JONATHAN WALDBAUM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034288

License Status

EXPIRED

Business

First Name

JONATHAN

Last Name

WALDBAUM

Business Name

JONATHAN WALDBAUM

Original Issue Date

05/09/1996

Effective Date

05/09/1996

Expiration Date

06/17/1999

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006