ILYSSA OKRENT GORDON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051211

License Status

CANCELLED

Business

First Name

ILYSSA

Middle

OKRENT

Last Name

GORDON

Suffix

Business Name

ILYSSA OKRENT GORDON MD

Original Issue Date

06/24/2006

Effective Date

06/24/2006

Expiration Date

06/23/2009

City

CLEVELAND

State

Zip

44195

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/22/2006