JENNIFER K TAKATA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036537

License Status

EXPIRED

Business

First Name

JENNIFER

Middle

Last Name

TAKATA

Suffix

Business Name

JENNIFER K TAKATA DO

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

06/30/2000

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006