JONATHAN RICHARD DANIELS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059130

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

RICHARD

Last Name

DANIELS

Business Name

JONATHAN RICHARD DANIELS MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

HAWTHORN WOODS

State

Zip

60060

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014