CHRISTINE LYNN GRUNDEMAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060120

License Status

CANCELLED

Business

Title

First Name

CHRISTINE

Middle

LYNN

Last Name

GRUNDEMAN

Business Name

CHRISTINE LYNN GRUNDEMAN DO

Original Issue Date

06/20/2011

Effective Date

06/20/2011

Expiration Date

06/19/2014

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

03/24/2014