KATELYN ELIZABETH BURGESS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066514

License Status

CANCELLED

Business

Title

First Name

KATELYN

Middle

ELIZABETH

Last Name

BURGESS

Business Name

KATELYN ELIZABETH BURGESS MD

Original Issue Date

06/23/2015

Effective Date

06/23/2015

Expiration Date

06/22/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/13/2015