SUSAN MARIE COLEGROVE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069188

License Status

CANCELLED

Business

Title

First Name

SUSAN

Middle

MARIE

Last Name

COLEGROVE

Business Name

SUSAN MARIE COLEGROVE MD

Original Issue Date

06/24/2016

Effective Date

06/24/2016

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/07/2016