JACK GOERGEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076512

License Status

CANCELLED

Business

Title

First Name

JACK

Last Name

GOERGEN

Business Name

JACK GOERGEN MD

Original Issue Date

06/21/2020

Effective Date

06/21/2020

Expiration Date

06/22/2023

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/13/2020