DEWAYNE COLLINS Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032584

License Status

CANCELLED

Business

First Name

DEWAYNE

Last Name

COLLINS

Business Name

DEWAYNE COLLINS

Original Issue Date

05/19/1995

Effective Date

05/19/1995

Expiration Date

05/11/2002

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006