JEAN ELLYN DYKSTRA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047325

License Status

EXPIRED

Business

First Name

JEAN

Middle

ELLYN

Last Name

DYKSTRA

Suffix

Business Name

JEAN ELLYN DYKSTRA DO

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2009

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/15/2009