THOMAS BACKUS DANIELS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045775

License Status

EXPIRED

Business

First Name

THOMAS

Middle

BACKUS

Last Name

DANIELS

Suffix

Business Name

THOMAS BACKUS DANIELS MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006