JASON EVERETT KOOCH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041741

License Status

CANCELLED

Business

First Name

JASON

Middle

EVERETT

Last Name

KOOCH

Suffix

Business Name

JASON EVERETT KOOCH DO

Original Issue Date

06/20/2000

Effective Date

06/20/2000

Expiration Date

06/19/2003

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006