TRAVIS BERNARD DESA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070080

License Status

EXPIRED

Business

Title

First Name

TRAVIS

Middle

BERNARD

Last Name

DESA

Business Name

TRAVIS BERNARD DESA MD

Original Issue Date

06/22/2018

Effective Date

06/22/2018

Expiration Date

06/21/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

11/19/2020