JUSTIN MICHAEL DAGRACA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055630

License Status

CANCELLED

Business

Title

First Name

JUSTIN

Middle

MICHAEL

Last Name

DAGRACA

Business Name

JUSTIN MICHAEL DAGRACA MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

WARRENVILLE

State

Zip

60555

County

DUPAGE

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

03/12/2009