DAVID A VAN DYKE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016322

License Status

EXPIRED

Business

First Name

DAVID

Middle

Last Name

VAN DYKE

Business Name

DAVID A VAN DYKE

Original Issue Date

08/01/1983

Effective Date

08/01/1983

Expiration Date

07/01/1985

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006