PAOLA SUSAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061411

License Status

CANCELLED

Business

Title

First Name

PAOLA

Last Name

SUSAN

Business Name

PAOLA SUSAN MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014