DWAYNE BERNARD BUCHANAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053019

License Status

CANCELLED

Business

First Name

DWAYNE

Middle

BERNARD

Last Name

BUCHANAN

Suffix

Business Name

DWAYNE BERNARD BUCHANAN MD

Original Issue Date

06/25/2007

Effective Date

06/25/2007

Expiration Date

06/24/2010

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/01/2007