BETHANY MARY JENGIC MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071500

License Status

CANCELLED

Business

Title

First Name

BETHANY

Middle

MARY

Last Name

JENGIC

Business Name

BETHANY MARY JENGIC MD

Original Issue Date

07/05/2018

Effective Date

07/05/2018

Expiration Date

07/04/2020

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/05/2018