MARK DANIEL FOLKERTSMA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062188

License Status

EXPIRED

Business

Title

First Name

MARK

Middle

DANIEL

Last Name

FOLKERTSMA

Business Name

MARK DANIEL FOLKERTSMA MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/07/2013