JENNIFER K TAKATA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101361

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

TAKATA

Suffix

Business Name

JENNIFER K TAKATA DO

Original Issue Date

09/28/1999

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008