SHOSHANA ERIN INDENBAUM GORDON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070316

License Status

EXPIRED

Business

Title

First Name

SHOSHANA

Middle

ERIN INDENBAUM

Last Name

GORDON

Business Name

SHOSHANA ERIN INDENBAUM GORDON DO

Original Issue Date

06/29/2020

Effective Date

06/29/2020

Expiration Date

07/21/2020

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020