DILLON JED BANNIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063348

License Status

CANCELLED

Business

Title

First Name

DILLON

Middle

JED

Last Name

BANNIS

Business Name

DILLON JED BANNIS MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

04/12/2016