JACK W MILLER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057450

License Status

INACTIVE

Business

First Name

JACK W

Last Name

MILLER

Suffix

Business Name

JACK W MILLER MD

Original Issue Date

08/21/1978

Effective Date

08/21/1978

Expiration Date

07/31/1993

City

GREAT LAKES

State

Zip

60088

County

LAKE

Ever Disciplined

LastModifiedDate

09/20/2006