DONNA J BACKUS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034076

License Status

EXPIRED

Business

First Name

DONNA

Middle

Last Name

BACKUS

Business Name

DONNA J BACKUS

Original Issue Date

05/02/1996

Effective Date

05/02/1996

Expiration Date

06/30/1999

City

PRAK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006