GRACE A CARLSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055043

License Status

EXPIRED

Business

First Name

GRACE A

Last Name

CARLSON

Business Name

GRACE A CARLSON

Original Issue Date

06/30/2009

Effective Date

06/30/2009

Expiration Date

06/29/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/19/2011