JACLYN FRANCES EISENBERG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059894

License Status

CANCELLED

Business

Title

First Name

JACLYN

Middle

FRANCES

Last Name

EISENBERG

Business Name

JACLYN FRANCES EISENBERG DO

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/17/2011