SPENCER SUPPES DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076420

License Status

CANCELLED

Business

Title

First Name

SPENCER

Last Name

SUPPES

Business Name

SPENCER SUPPES DO

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/04/2020