CARLY JACQUELINE ROMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063208

License Status

EXPIRED

Business

First Name

CARLY

Middle

JACQUELINE

Last Name

ROMAN

Suffix

Business Name

CARLY JACQUELINE ROMAN MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/19/2017