ADAM RANDOLPH TRAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127714

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

RANDOLPH

Last Name

TRAVIS

Business Name

ADAM RANDOLPH TRAVIS MD

Original Issue Date

04/26/2011

Effective Date

07/31/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017