DAVID PARKER FAXON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102276

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

PARKER

Last Name

FAXON

Suffix

Business Name

DAVID PARKER FAXON MD

Original Issue Date

04/05/2000

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008