THEODORE GILL HART MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065360

License Status

CANCELLED

Business

Title

First Name

THEODORE

Middle

GILL

Last Name

HART

Business Name

THEODORE GILL HART MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

01/24/2017