JIANSAN GU MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073853

License Status

CANCELLED

Business

Title

First Name

JIANSAN

Last Name

Business Name

JIANSAN GU MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2022

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/09/2019