LOUIS MICHAEL REVENIG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065967

License Status

CANCELLED

Business

Title

First Name

LOUIS

Middle

MICHAEL

Last Name

REVENIG

Business Name

LOUIS MICHAEL REVENIG MD

Original Issue Date

06/27/2014

Effective Date

06/27/2014

Expiration Date

06/26/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

06/27/2014