JACQUELYN TARA BUSSE MD - Medical Doctor License in Illinois | # 125051144

JACQUELYN TARA BUSSE MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051144

License Status

EXPIRED

Business

N

First Name

JACQUELYN

Middle

TARA

Last Name

BUSSE

Suffix

MD

Business Name

JACQUELYN TARA BUSSE MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

07/15/2009