JEFFREY JOHN PETRUSEK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069434

License Status

CANCELLED

Business

Title

First Name

JEFFREY

Middle

JOHN

Last Name

PETRUSEK

Business Name

JEFFREY JOHN PETRUSEK MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

05/04/2019