DANIEL MARK HOMUTH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071054

License Status

EXPIRED

Business

Title

First Name

DANIEL

Middle

MARK

Last Name

HOMUTH

Business Name

DANIEL MARK HOMUTH MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

10/11/2022