JOHN WARREN EBERSOLE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061655

License Status

CANCELLED

Business

Title

First Name

JOHN

Middle

WARREN

Last Name

EBERSOLE

Business Name

JOHN WARREN EBERSOLE MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

04/21/2015