JAN L IWATA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032986

License Status

EXPIRED

Business

First Name

JAN L

Last Name

IWATA

Business Name

JAN L IWATA

Original Issue Date

06/03/1995

Effective Date

06/03/1995

Expiration Date

06/20/1999

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006