JONATHAN RODERICK DUTT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071354

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

RODERICK

Last Name

DUTT

Business Name

JONATHAN RODERICK DUTT MD

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/05/2017