JASON FALLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057643

License Status

NOT RENEWED

Business

First Name

JASON

Last Name

FALLER

Suffix

Business Name

JASON FALLER MD

Original Issue Date

09/25/1978

Effective Date

09/25/1978

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006