JONATHAN ALEXANDER CHURCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068210

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

ALEXANDER

Last Name

CHURCH

Business Name

JONATHAN ALEXANDER CHURCH MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/09/2016