JACK STROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042973

License Status

NOT RENEWED

Business

First Name

JACK

Last Name

STROM

Suffix

Business Name

JACK STROM MD

Original Issue Date

09/26/1969

Effective Date

09/26/1969

Expiration Date

07/31/1999

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006