WILLARD SANTOS PALUSTRE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066361

License Status

CANCELLED

Business

Title

First Name

WILLARD

Middle

SANTOS

Last Name

PALUSTRE

Business Name

WILLARD SANTOS PALUSTRE MD

Original Issue Date

06/22/2015

Effective Date

06/22/2015

Expiration Date

06/21/2018

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/07/2015