KEVIN DOUGLAS HEINZE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073869

License Status

CANCELLED

Business

Title

First Name

KEVIN

Middle

DOUGLAS

Last Name

HEINZE

Business Name

KEVIN DOUGLAS HEINZE MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

05/10/2019