KEVIN MICHAEL SURFACE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001183

License Status

EXPIRED

Business

Title

First Name

KEVIN

Middle

MICHAEL

Last Name

SURFACE

Business Name

KEVIN MICHAEL SURFACE DO

Original Issue Date

10/23/2017

Effective Date

10/23/2017

Expiration Date

11/22/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

01/04/2018