DUSTIN KEITH JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056980

License Status

CANCELLED

Business

Title

First Name

DUSTIN

Middle

KEITH

Last Name

JOHNSON

Business Name

DUSTIN KEITH JOHNSON MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

04/12/2010