DAVID HERBERT SLADE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061327

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

HERBERT

Last Name

SLADE

Business Name

DAVID HERBERT SLADE MD

Original Issue Date

06/22/2012

Effective Date

06/22/2012

Expiration Date

06/21/2015

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014