DAVID JEREMY DAVIDSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053047

License Status

CANCELLED

Business

First Name

DAVID

Middle

JEREMY

Last Name

DAVIDSON

Suffix

Business Name

DAVID JEREMY DAVIDSON MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

BANNOCKBURN

State

Zip

60015

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/16/2007