DAVID JEFFREY MOLLER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046558

License Status

CANCELLED

Business

First Name

DAVID

Middle

JEFFREY

Last Name

MOLLER

Suffix

Business Name

DAVID JEFFREY MOLLER MD

Original Issue Date

06/21/2003

Effective Date

06/21/2003

Expiration Date

06/20/2008

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

09/22/2006