DAVID JOHN SURPRENANT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070659

License Status

EXPIRED

Business

Title

First Name

DAVID

Middle

JOHN

Last Name

SURPRENANT

Business Name

DAVID JOHN SURPRENANT MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

11/19/2020