JEFFREY JON QUACKENBUSH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034885

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

JON

Last Name

QUACKENBUSH

Business Name

JEFFREY JON QUACKENBUSH

Original Issue Date

06/05/1996

Effective Date

06/05/1996

Expiration Date

06/30/1997

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006