JACK FITZSIMONS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078448

License Status

CANCELLED

Business

Title

First Name

JACK

Last Name

FITZSIMONS

Business Name

JACK FITZSIMONS MD

Original Issue Date

06/22/2022

Effective Date

06/22/2022

Expiration Date

06/21/2024

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/07/2022