JILLIAN M HALLSTROM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027637

License Status

EXPIRED

Business

First Name

JILLIAN

Middle

Last Name

HALLSTROM

Business Name

JILLIAN M HALLSTROM

Original Issue Date

03/17/1992

Effective Date

03/17/1992

Expiration Date

03/31/1996

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006