DAVID KEEGAN STOMBAUGH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066925

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

KEEGAN

Last Name

STOMBAUGH

Business Name

DAVID KEEGAN STOMBAUGH MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Adult Cardiothoracic Anesthesiology

Ever Disciplined

LastModifiedDate

01/13/2020