JOSHUA WILLIAM DAWALT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046039

License Status

CANCELLED

Business

First Name

JOSHUA

Middle

WILLIAM

Last Name

DAWALT

Business Name

JOSHUA WILLIAM DAWALT

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006