MATTHEW THOMAS GENCO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072576

License Status

CANCELLED

Business

Title

First Name

MATTHEW

Middle

THOMAS

Last Name

GENCO

Business Name

MATTHEW THOMAS GENCO MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/30/2018