JASON EVERETT KOOCH DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108841

License Status

NOT RENEWED

Business

First Name

JASON

Middle

EVERETT

Last Name

KOOCH

Suffix

Business Name

JASON EVERETT KOOCH DO

Original Issue Date

03/20/2003

Effective Date

03/20/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006