STACY A COHEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056968

License Status

CANCELLED

Business

Title

First Name

STACY

Middle

Last Name

COHEN

Business Name

STACY A COHEN MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/12/2010