JAZZ DOMINIC KROEGER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083662

License Status

ACTIVE

Business

Title

First Name

JAZZ

Middle

DOMINIC

Last Name

KROEGER

Business Name

JAZZ DOMINIC KROEGER MD

Original Issue Date

06/26/2024

Effective Date

06/26/2024

Expiration Date

06/25/2027

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/09/2024