JEREMY MICHAEL VEENSTRA-VANDERWEELE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042876

License Status

CANCELLED

Business

First Name

JEREMY

Middle

MICHAEL

Last Name

VEENSTRA-VANDERWEELE

Suffix

Business Name

JEREMY MICHAEL VEENSTRA-VANDERWEELE MD

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Child & Adolescent Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006