JACK S HAVDALA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025371

License Status

EXPIRED

Business

First Name

JACK S

Last Name

HAVDALA

Suffix

Business Name

JACK S HAVDALA MD

Original Issue Date

06/07/1990

Effective Date

06/07/1990

Expiration Date

06/30/1991

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006