DAVID CROCKETT WOODLAND MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144367

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

CROCKETT

Last Name

WOODLAND

Business Name

DAVID CROCKETT WOODLAND MD

Original Issue Date

09/21/2017

Effective Date

09/21/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021