FORREST PENDLETON ALLEN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062006

License Status

CANCELLED

Business

Title

First Name

FORREST

Middle

PENDLETON

Last Name

ALLEN

Business Name

FORREST PENDLETON ALLEN DO

Original Issue Date

06/25/2012

Effective Date

06/25/2012

Expiration Date

06/24/2015

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014