KEVIN S WALL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030634

License Status

EXPIRED

Business

First Name

KEVIN

Middle

Last Name

WALL

Business Name

KEVIN S WALL

Original Issue Date

07/12/1993

Effective Date

07/12/1993

Expiration Date

07/11/1996

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006