DANIEL FORREST CHILD DO - Medical Doctor License in Illinois | # 125062820

DANIEL FORREST CHILD DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062820

License Status

CANCELLED

Business

N

Title

DO

First Name

DANIEL

Middle

FORREST

Last Name

CHILD

Business Name

DANIEL FORREST CHILD DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

State

IL

Specialty/Qualifier

Family Practice

Ever Disciplined

N

LastModifiedDate

03/24/2014