JORDAN DALE WAXMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037317

License Status

NOT RENEWED

Business

First Name

JORDAN DALE

Last Name

WAXMAN

Suffix

Business Name

JORDAN DALE WAXMAN MD

Original Issue Date

09/14/1961

Effective Date

04/08/2011

Expiration Date

07/31/2014

City

WILMETTE

State

Zip

60091

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014