JEREMY DAVID STAYTON MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135347

License Status

INACTIVE

Business

Title

First Name

JEREMY

Middle

DAVID

Last Name

STAYTON

Business Name

JEREMY DAVID STAYTON MD

Original Issue Date

05/16/2014

Effective Date

05/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

02/06/2019