TAE JOSEPH GARDNER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054429

License Status

EXPIRED

Business

Title

First Name

TAE

Middle

JOSEPH

Last Name

GARDNER

Business Name

TAE JOSEPH GARDNER MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/13/2015