JEFFREY JON QUACKENBUSH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105959

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

JON

Last Name

QUACKENBUSH

Business Name

JEFFREY JON QUACKENBUSH

Original Issue Date

12/07/2001

Effective Date

12/07/2001

Expiration Date

07/31/2002

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006