JAMIE BRENNA WABICH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062051

License Status

CANCELLED

Business

Title

First Name

JAMIE

Middle

BRENNA

Last Name

WABICH

Business Name

JAMIE BRENNA WABICH MD

Original Issue Date

06/23/2012

Effective Date

06/23/2012

Expiration Date

06/22/2015

City

LAKE FOREST

State

Zip

60045

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014