JASON WYETH KOOB MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056901

License Status

EXPIRED

Business

First Name

JASON

Middle

WYETH

Last Name

KOOB

Suffix

Business Name

JASON WYETH KOOB MD

Original Issue Date

06/23/2013

Effective Date

06/23/2013

Expiration Date

06/22/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/13/2015