JOSEPH MICHAEL DEBARTOLO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065443

License Status

CANCELLED

Business

Title

First Name

JOSEPH

Middle

MICHAEL

Last Name

DEBARTOLO

Business Name

JOSEPH MICHAEL DEBARTOLO MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/26/2015