LAURENCE AUSTIN DONAHUE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057552

License Status

CANCELLED

Business

Title

First Name

LAURENCE

Middle

AUSTIN

Last Name

DONAHUE

Business Name

LAURENCE AUSTIN DONAHUE MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/24/2014