ADAM WINSTON TAVES MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051141

License Status

CANCELLED

Business

First Name

ADAM

Middle

WINSTON

Last Name

TAVES

Suffix

Business Name

ADAM WINSTON TAVES MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2011

City

RICHMOND HEIGHTS

State

Zip

63117

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/15/2009