SELENE CLARISSA KOO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059369

License Status

CANCELLED

Business

Title

First Name

SELENE

Middle

CLARISSA

Last Name

KOO

Business Name

SELENE CLARISSA KOO MD

Original Issue Date

06/24/2014

Effective Date

06/24/2014

Expiration Date

06/23/2015

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

04/16/2014