JEREMY DWAINE DAIGLE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057026

License Status

CANCELLED

Business

Title

First Name

JEREMY

Middle

DWAINE

Last Name

DAIGLE

Business Name

JEREMY DWAINE DAIGLE MD

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2012

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

06/03/2009