JAY ADAM GOTTFRIED Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112080

License Status

NOT RENEWED

Business

First Name

JAY

Middle

ADAM

Last Name

GOTTFRIED

Business Name

JAY ADAM GOTTFRIED

Original Issue Date

08/10/2004

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021