ROSS DANIEL COOLIDGE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067998

License Status

CANCELLED

Business

Title

First Name

ROSS

Middle

DANIEL

Last Name

COOLIDGE

Business Name

ROSS DANIEL COOLIDGE DO

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

03/25/2016