CORNE VAN DER WALT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055348

License Status

CANCELLED

Business

Title

First Name

CORNE

Last Name

VAN DER WALT

Business Name

CORNE VAN DER WALT MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/19/2008