THEODORE BRETT JEFFERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045122

License Status

EXPIRED

Business

First Name

THEODORE

Middle

BRETT

Last Name

JEFFERSON

Suffix

Business Name

THEODORE BRETT JEFFERSON MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

07/02/2005

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006