JENNIFER REAVIS DECKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129361

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

REAVIS

Last Name

DECKER

Business Name

JENNIFER REAVIS DECKER MD

Original Issue Date

12/14/2011

Effective Date

12/14/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014