DAVID MICHAEL DICKERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054403

License Status

EXPIRED

Business

Title

First Name

DAVID

Middle

MICHAEL

Last Name

DICKERSON

Business Name

DAVID MICHAEL DICKERSON MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2012

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

08/29/2012