JORDAN CLAIRE CARQUEVILLE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053046

License Status

EXPIRED

Business

Title

First Name

JORDAN

Middle

CLAIRE

Last Name

CARQUEVILLE

Business Name

JORDAN CLAIRE CARQUEVILLE MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

07/19/2011