JONATHAN C VANDENBERG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066293

License Status

EXPIRED

Business

Title

First Name

JONATHAN

Middle

Last Name

VANDENBERG

Business Name

JONATHAN C VANDENBERG DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

10/02/2019