JEREMY RAIDER ESTRADA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056053

License Status

EXPIRED

Business

Title

First Name

JEREMY

Middle

RAIDER

Last Name

ESTRADA

Business Name

JEREMY RAIDER ESTRADA MD

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2012

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012