ARIELLE NICOLE PORT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064517

License Status

CANCELLED

Business

Title

First Name

ARIELLE

Middle

NICOLE

Last Name

PORT

Business Name

ARIELLE NICOLE PORT MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/14/2014