XANE DONOVAN PETERS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076365

License Status

CANCELLED

Business

Title

First Name

XANE

Middle

DONOVAN

Last Name

PETERS

Business Name

XANE DONOVAN PETERS MD

Original Issue Date

06/22/2020

Effective Date

06/22/2020

Expiration Date

06/21/2023

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

04/16/2020