MERRICK JAY DONENBERG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060335

License Status

EXPIRED

Business

Title

First Name

MERRICK

Middle

JAY

Last Name

DONENBERG

Business Name

MERRICK JAY DONENBERG MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

OTTAWA

State

Zip

61350

County

LA SALLE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/13/2015