RAVEN JEANINE HOLLAND MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063109

License Status

CANCELLED

Business

Title

First Name

RAVEN

Middle

JEANINE

Last Name

HOLLAND

Business Name

RAVEN JEANINE HOLLAND MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60653

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014