MICHAEL CHISUM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001378

License Status

EXPIRED

Business

Title

First Name

MICHAEL

Last Name

CHISUM

Business Name

MICHAEL CHISUM MD

Original Issue Date

02/11/2021

Effective Date

02/11/2021

Expiration Date

05/10/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

07/20/2021