JENNA MAE MAMATOV DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081557

License Status

ACTIVE

Business

Title

First Name

JENNA

Middle

MAE

Last Name

MAMATOV

Business Name

JENNA MAE MAMATOV DO

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/13/2023