GREGORY OWEN ANDERSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064082

License Status

CANCELLED

Business

Title

First Name

GREGORY

Middle

OWEN

Last Name

ANDERSON

Business Name

GREGORY OWEN ANDERSON DO

Original Issue Date

12/02/2016

Effective Date

12/02/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

12/02/2016