JOHANNA KRISTEN FOX MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065972

License Status

EXPIRED

Business

Title

First Name

JOHANNA

Middle

KRISTEN

Last Name

FOX

Business Name

JOHANNA KRISTEN FOX MD

Original Issue Date

06/23/2017

Effective Date

06/23/2017

Expiration Date

06/22/2019

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/02/2019