SARA LYNN FOSSUM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071737

License Status

EXPIRED

Business

Title

First Name

SARA

Middle

LYNN

Last Name

FOSSUM

Business Name

SARA LYNN FOSSUM MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019