JACQUELINE TRINIDAD CHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062259

License Status

CANCELLED

Business

Title

First Name

JACQUELINE

Middle

TRINIDAD

Last Name

CHAN

Business Name

JACQUELINE TRINIDAD CHAN MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/23/2015