JONATHAN D POWELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041249

License Status

EXPIRED

Business

First Name

JONATHAN

Middle

Last Name

POWELL

Suffix

Business Name

JONATHAN D POWELL MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

06/27/2003

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006