SUSANNE K VANDERBILT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057843

License Status

EXPIRED

Business

First Name

SUSANNE

Middle

Last Name

VANDERBILT

Suffix

Business Name

SUSANNE K VANDERBILT MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012