ANDREW MICHAEL DAHLEM MD - Medical Doctor License in Illinois | # 125063047

ANDREW MICHAEL DAHLEM MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063047

License Status

CANCELLED

Business

N

Title

MD

First Name

ANDREW

Middle

MICHAEL

Last Name

DAHLEM

Business Name

ANDREW MICHAEL DAHLEM MD

Original Issue Date

06/25/2013

Effective Date

06/25/2013

Expiration Date

06/24/2016

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

03/24/2014