JEREMY DAVID STAYTON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060385

License Status

EXPIRED

Business

Title

First Name

JEREMY

Middle

DAVID

Last Name

STAYTON

Business Name

JEREMY DAVID STAYTON MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/13/2015