JAMES DRISCOLL GENDERNALIK DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062162

License Status

EXPIRED

Business

Title

First Name

JAMES

Middle

DRISCOLL

Last Name

GENDERNALIK

Business Name

JAMES DRISCOLL GENDERNALIK DO

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/04/2015