JONATHAN RUSSELL THOMULKA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071515

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

RUSSELL

Last Name

THOMULKA

Business Name

JONATHAN RUSSELL THOMULKA DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60625

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/22/2017