KENNETH J VAN DYKE JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000619

License Status

EXPIRED

Business

First Name

KENNETH

Middle

Last Name

VAN DYKE

Suffix

JR MD

Business Name

KENNETH J VAN DYKE JR MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

07/31/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/25/2006