JASON MATTHEW YAX DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040045

License Status

CANCELLED

Business

First Name

JASON

Middle

MATTHEW

Last Name

YAX

Suffix

Business Name

JASON MATTHEW YAX DO

Original Issue Date

06/21/1999

Effective Date

06/21/1999

Expiration Date

06/20/2004

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006