ARIEL NICOLE MAGALLON DONNELLY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075536

License Status

CANCELLED

Business

Title

First Name

ARIEL

Middle

NICOLE

Last Name

MAGALLON DONNELLY

Business Name

ARIEL NICOLE MAGALLON DONNELLY MD

Original Issue Date

06/23/2020

Effective Date

06/23/2020

Expiration Date

06/22/2023

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/08/2020