TATUM SIMON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000524

License Status

EXPIRED

Business

First Name

TATUM

Last Name

SIMON

Suffix

Business Name

TATUM SIMON MD

Original Issue Date

06/06/2001

Effective Date

06/06/2001

Expiration Date

07/05/2001

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/25/2006