CHARLES E SWANSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073815

License Status

CANCELLED

Business

Title

First Name

CHARLES

Middle

Last Name

SWANSON

Business Name

CHARLES E SWANSON DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/09/2019