WALTER DANTE CONWELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052673

License Status

CANCELLED

Business

Title

First Name

WALTER

Middle

DANTE

Last Name

CONWELL

Business Name

WALTER DANTE CONWELL MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/18/2007