BRIAN PATRICK DOUGHERTY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062127

License Status

CANCELLED

Business

Title

First Name

BRIAN

Middle

PATRICK

Last Name

DOUGHERTY

Business Name

BRIAN PATRICK DOUGHERTY MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

NORTH CHICAGO

State

Zip

60088

County

LAKE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014