PHILLIP DOUGLAS MARTINEZ-KNOUSE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068926

License Status

CANCELLED

Business

Title

First Name

PHILLIP

Middle

DOUGLAS

Last Name

MARTINEZ-KNOUSE

Business Name

PHILLIP DOUGLAS MARTINEZ-KNOUSE MD

Original Issue Date

06/25/2016

Effective Date

06/25/2016

Expiration Date

06/24/2019

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/31/2016