JACQUELYN TARA BUSSE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051144

License Status

EXPIRED

Business

First Name

JACQUELYN

Middle

TARA

Last Name

BUSSE

Suffix

Business Name

JACQUELYN TARA BUSSE MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/15/2009