JASON S BURGESS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104424

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

BURGESS

Suffix

Business Name

JASON S BURGESS MD

Original Issue Date

03/30/2001

Effective Date

03/30/2001

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006