JUSTIN ROBERT MILLER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000253

License Status

CANCELLED

Business

First Name

JUSTIN

Middle

ROBERT

Last Name

MILLER

Suffix

Business Name

JUSTIN ROBERT MILLER DO

Original Issue Date

08/30/2005

Effective Date

08/30/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006