JERRY VILLASENOR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043307

License Status

EXPIRED

Business

First Name

JERRY

Last Name

VILLASENOR

Business Name

JERRY VILLASENOR

Original Issue Date

06/25/2001

Effective Date

06/25/2001

Expiration Date

06/24/2004

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006