DUSTIN ALLAN CARLSON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055725

License Status

CANCELLED

Business

First Name

DUSTIN

Middle

ALLAN

Last Name

CARLSON

Business Name

DUSTIN ALLAN CARLSON

Original Issue Date

06/23/2009

Effective Date

06/23/2009

Expiration Date

06/22/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/22/2009