ANDREW MICHAEL DAHLEM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063047

License Status

CANCELLED

Business

Title

First Name

ANDREW

Middle

MICHAEL

Last Name

DAHLEM

Business Name

ANDREW MICHAEL DAHLEM MD

Original Issue Date

06/25/2013

Effective Date

06/25/2013

Expiration Date

06/24/2016

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014