KARLIE SUZANNE SAMPLE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084245

License Status

ACTIVE

Business

First Name

KARLIE

Middle

SUZANNE

Last Name

SAMPLE

Business Name

KARLIE SUZANNE SAMPLE

Original Issue Date

06/24/2024

Effective Date

06/24/2024

Expiration Date

06/23/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/23/2024