DARNELLA D GIST Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037574

License Status

EXPIRED

Business

First Name

DARNELLA

Middle

Last Name

GIST

Business Name

DARNELLA D GIST

Original Issue Date

05/08/1998

Effective Date

05/08/1998

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006