MARK T BAMMAN MD - Medical Doctor License in Illinois | # 125064564

MARK T BAMMAN MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064564

License Status

CANCELLED

Business

N

First Name

MARK

Middle

T

Last Name

BAMMAN

Suffix

MD

Business Name

MARK T BAMMAN MD

Original Issue Date

06/23/2014

Effective Date

06/23/2014

Expiration Date

06/22/2017

State

IL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

N

LastModifiedDate

05/19/2014