JACK N POWITZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045466

License Status

EXPIRED

Business

First Name

JACK

Middle

Last Name

POWITZ

Business Name

JACK N POWITZ

Original Issue Date

01/09/2003

Effective Date

01/09/2003

Expiration Date

01/08/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

01/26/2007