EVERETT LAWRENCE WEISS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047471

License Status

CANCELLED

Business

First Name

EVERETT

Middle

LAWRENCE

Last Name

WEISS

Suffix

Business Name

EVERETT LAWRENCE WEISS MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006