TESSA LORRAINE QUALKINBUSH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069505

License Status

CANCELLED

Business

Title

First Name

TESSA

Middle

LORRAINE

Last Name

QUALKINBUSH

Business Name

TESSA LORRAINE QUALKINBUSH MD

Original Issue Date

06/25/2016

Effective Date

06/25/2016

Expiration Date

06/24/2019

City

CHICAGO

State

Zip

60609

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/26/2019