ALAN DAVID VAN OPSTAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054791

License Status

CANCELLED

Business

Title

First Name

ALAN

Middle

DAVID

Last Name

VAN OPSTAL

Business Name

ALAN DAVID VAN OPSTAL MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/07/2008