CRYSTAL GRACE BOCKOVEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069585

License Status

EXPIRED

Business

Title

First Name

CRYSTAL

Middle

GRACE

Last Name

BOCKOVEN

Business Name

CRYSTAL GRACE BOCKOVEN MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

11/19/2020