JORDAN ALEXANDER DALE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061669

License Status

CANCELLED

Business

Title

First Name

JORDAN

Middle

ALEXANDER

Last Name

DALE

Business Name

JORDAN ALEXANDER DALE MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014