EVAN AUGUSTINE DOUGHERTY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056811

License Status

CANCELLED

Business

Title

First Name

EVAN

Middle

AUGUSTINE

Last Name

DOUGHERTY

Business Name

EVAN AUGUSTINE DOUGHERTY MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

HINSDALE

State

Zip

60521

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

03/24/2014