JERRY L MOTHERSHEAD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027217

License Status

EXPIRED

Business

First Name

JERRY

Middle

Last Name

MOTHERSHEAD

Business Name

JERRY L MOTHERSHEAD

Original Issue Date

06/19/1991

Effective Date

06/19/1991

Expiration Date

08/19/1994

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006

Case Number

1991004214

Action

Probation

Discipline Start Date

07/19/1994

Discipline End Date

08/19/1994

Discipline Reason

Violated the terms and conditions of his Agreement of Care, Counseling and Treatment, in that he relapsed on alcohol.