ERIC DONALD DONNELLY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054036

License Status

CANCELLED

Business

Title

First Name

ERIC

Middle

DONALD

Last Name

DONNELLY

Business Name

ERIC DONALD DONNELLY MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Radiation Oncology

Ever Disciplined

LastModifiedDate

04/14/2011