JERRY PAUL PETASNICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038834

License Status

NOT RENEWED

Business

First Name

JERRY PAUL

Last Name

PETASNICK

Suffix

Business Name

JERRY PAUL PETASNICK MD

Original Issue Date

11/26/1963

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021