JACLYN PAIGE WINIKOFF WALLIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057543

License Status

CANCELLED

Business

Title

First Name

JACLYN

Middle

PAIGE

Last Name

WINIKOFF WALLIS

Business Name

JACLYN PAIGE WINIKOFF WALLIS MD

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

06/22/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/04/2010