TIMOTHY PHILIP HALT DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053099

License Status

CANCELLED

Business

Title

First Name

TIMOTHY

Middle

PHILIP

Last Name

HALT

Business Name

TIMOTHY PHILIP HALT DO

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/24/2007