EVAN ROSS GOODMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067940

License Status

CANCELLED

Business

Title

First Name

EVAN

Middle

ROSS

Last Name

GOODMAN

Business Name

EVAN ROSS GOODMAN MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

01/27/2016