DAVID DAVENPORT BEAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063095

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

DAVENPORT

Last Name

BEAL

Business Name

DAVID DAVENPORT BEAL MD

Original Issue Date

06/26/2013

Effective Date

06/26/2013

Expiration Date

06/25/2016

City

NEW LENOX

State

Zip

60451

County

WILL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/24/2014