LOGAN K CHASTAIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066956

License Status

EXPIRED

Business

Title

First Name

LOGAN

Middle

Last Name

CHASTAIN

Business Name

LOGAN K CHASTAIN MD

Original Issue Date

06/26/2018

Effective Date

06/26/2018

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

11/19/2020