JOHN R DEFOREST DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028329

License Status

EXPIRED

Business

First Name

JOHN R

Last Name

DEFOREST

Suffix

Business Name

JOHN R DEFOREST DO

Original Issue Date

05/26/1992

Effective Date

05/26/1992

Expiration Date

06/21/1995

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006