MINTA MARY MATHEW Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000692

License Status

NOT RENEWED

Business

First Name

MINTA

Middle

MARY

Last Name

MATHEW

Business Name

MINTA MARY MATHEW

Original Issue Date

08/02/2006

Effective Date

08/02/2006

Expiration Date

09/01/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Allergy & Immunology

Ever Disciplined

LastModifiedDate

11/03/2006