WALTER DANTE CONWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125663

License Status

NOT RENEWED

Business

Title

First Name

WALTER

Middle

DANTE

Last Name

CONWELL

Business Name

WALTER DANTE CONWELL MD

Original Issue Date

05/04/2010

Effective Date

05/04/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011