DOUGLAS R WITHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055201

License Status

NOT RENEWED

Business

First Name

DOUGLAS R

Last Name

WITHAM

Suffix

Business Name

DOUGLAS R WITHAM MD

Original Issue Date

07/22/1977

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/17/2014