LISA OMATEE TILLUCKDHARRY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000637

License Status

EXPIRED

Business

First Name

LISA

Middle

OMATEE

Last Name

TILLUCKDHARRY

Suffix

Business Name

LISA OMATEE TILLUCKDHARRY MD

Original Issue Date

09/20/2004

Effective Date

09/20/2004

Expiration Date

10/26/2004

City

CHICAGO

State

Zip

60637

Ever Disciplined

LastModifiedDate

09/25/2006