TRAVIS TAKANORI YAMANAKA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056843

License Status

CANCELLED

Business

Title

First Name

TRAVIS

Middle

TAKANORI

Last Name

YAMANAKA

Business Name

TRAVIS TAKANORI YAMANAKA MD

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2012

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/22/2009