STONEWALL MCCUISTON JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018691

License Status

EXPIRED

Business

First Name

STONEWALL

Last Name

MCCUISTON JR

Suffix

Business Name

STONEWALL MCCUISTON JR MD

Original Issue Date

06/20/1985

Effective Date

06/20/1985

Expiration Date

07/01/1988

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006