JORDAN ANTHONY MAIVELETT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068371

License Status

EXPIRED

Business

Title

First Name

JORDAN

Middle

ANTHONY

Last Name

MAIVELETT

Business Name

JORDAN ANTHONY MAIVELETT MD

Original Issue Date

06/23/2019

Effective Date

06/23/2019

Expiration Date

06/22/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/19/2020