JONATHAN MARTIN MONGOLD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063476

License Status

EXPIRED

Business

Title

First Name

JONATHAN

Middle

MARTIN

Last Name

MONGOLD

Business Name

JONATHAN MARTIN MONGOLD DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/16/2016