CORNE VAN DER WALT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127517

License Status

NOT RENEWED

Business

Title

First Name

CORNE

Last Name

VAN DER WALT

Business Name

CORNE VAN DER WALT MD

Original Issue Date

04/11/2011

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017