JOEL JEFFREY WACKERBARTH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069608

License Status

CANCELLED

Business

Title

First Name

JOEL

Middle

JEFFREY

Last Name

WACKERBARTH

Business Name

JOEL JEFFREY WACKERBARTH MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

02/09/2017