DAVE A DEANGELES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000183

License Status

EXPIRED

Business

First Name

DAVE

Middle

Last Name

DEANGELES

Business Name

DAVE A DEANGELES

Original Issue Date

12/02/2002

Effective Date

12/02/2002

Expiration Date

06/01/2003

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/23/2006