JOHN GORDON PROUT DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072197

License Status

CANCELLED

Business

Title

First Name

JOHN

Middle

GORDON

Last Name

PROUT

Business Name

JOHN GORDON PROUT DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

WHEATON

State

Zip

60189

County

DUPAGE

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/18/2018