DANIEL THEODORE LIS JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050022

License Status

EXPIRED

Business

First Name

DANIEL

Middle

THEODORE

Last Name

LIS JR

Suffix

Business Name

DANIEL THEODORE LIS JR MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/31/2008