GENS P GOODMAN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000907

License Status

EXPIRED

Business

First Name

GENS

Middle

Last Name

GOODMAN

Suffix

Business Name

GENS P GOODMAN DO

Original Issue Date

07/03/2012

Effective Date

07/03/2012

Expiration Date

01/02/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

03/20/2013