XA DWIGHT JOHNSON IV MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050023

License Status

EXPIRED

Business

First Name

Middle

DWIGHT

Last Name

JOHNSON

Suffix

IV MD

Business Name

XA DWIGHT JOHNSON IV MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006