AMANDA BLANCHE SIEGEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066532

License Status

CANCELLED

Business

Title

First Name

AMANDA

Middle

BLANCHE

Last Name

SIEGEL

Business Name

AMANDA BLANCHE SIEGEL MD

Original Issue Date

06/22/2015

Effective Date

06/22/2015

Expiration Date

06/21/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/13/2015