DANIEL ERICHSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125778

License Status

NOT RENEWED

Business

First Name

DANIEL

Last Name

ERICHSEN

Suffix

Business Name

DANIEL ERICHSEN MD

Original Issue Date

05/17/2010

Effective Date

05/17/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011