DAVID CROCKETT WOODLAND MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068023

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

CROCKETT

Last Name

WOODLAND

Business Name

DAVID CROCKETT WOODLAND MD

Original Issue Date

08/01/2016

Effective Date

08/01/2016

Expiration Date

07/31/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Transplantation Surgery

Ever Disciplined

LastModifiedDate

04/19/2016