ZACHARY DALE SEAGRAVE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062522

License Status

CANCELLED

Business

Title

First Name

ZACHARY

Middle

DALE

Last Name

SEAGRAVE

Business Name

ZACHARY DALE SEAGRAVE MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

03/24/2014