GRACE WILLERT FAULKNER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078551

License Status

CANCELLED

Business

Title

First Name

GRACE

Last Name

WILLERT FAULKNER

Business Name

GRACE WILLERT FAULKNER MD

Original Issue Date

06/24/2021

Effective Date

06/24/2021

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/10/2021