DANIEL DEBARTOLO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013926

License Status

EXPIRED

Business

First Name

DANIEL

Last Name

DEBARTOLO

Business Name

DANIEL DEBARTOLO

Original Issue Date

06/17/1982

Effective Date

06/17/1982

Expiration Date

07/01/1984

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006