MARTIN DAVID MILLER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047139

License Status

CANCELLED

Business

First Name

MARTIN

Middle

DAVID

Last Name

MILLER

Suffix

Business Name

MARTIN DAVID MILLER MD

Original Issue Date

12/08/2003

Effective Date

12/08/2003

Expiration Date

12/07/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006