EILEEN GRACE TENGCO DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056296

License Status

CANCELLED

Business

Title

First Name

EILEEN

Middle

GRACE

Last Name

TENGCO

Business Name

EILEEN GRACE TENGCO DO

Original Issue Date

06/22/2009

Effective Date

06/22/2009

Expiration Date

06/21/2012

City

PARK RIDGE

State

Zip

60098

County

MCHENRY

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/26/2009