JERE STAHL OZAETA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042676

License Status

CANCELLED

Business

First Name

JERE

Middle

STAHL

Last Name

OZAETA

Suffix

Business Name

JERE STAHL OZAETA MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006