DAISY MARAVILLA PROKSCH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077554

License Status

EXPIRED

Business

Title

First Name

DAISY

Middle

MARAVILLA

Last Name

PROKSCH

Business Name

DAISY MARAVILLA PROKSCH MD

Original Issue Date

06/23/2021

Effective Date

06/23/2021

Expiration Date

06/22/2022

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/11/2022