JENS THIELE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048259

License Status

EXPIRED

Business

First Name

JENS

Last Name

THIELE

Suffix

Business Name

JENS THIELE MD

Original Issue Date

06/27/2004

Effective Date

06/27/2004

Expiration Date

06/26/2005

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006