JONATHAN ALEXANDER CHURCH MD - Medical Doctor License in Illinois | # 125068210

JONATHAN ALEXANDER CHURCH MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068210

License Status

CANCELLED

Business

N

Title

MD

First Name

JONATHAN

Middle

ALEXANDER

Last Name

CHURCH

Business Name

JONATHAN ALEXANDER CHURCH MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

05/09/2016