THERESA M CONYAC MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056691

License Status

EXPIRED

Business

Title

First Name

THERESA

Middle

Last Name

CONYAC

Business Name

THERESA M CONYAC MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

08/29/2012