JACK PENROD WHITAKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084409

License Status

ACTIVE

Business

Title

First Name

JACK

Middle

PENROD

Last Name

WHITAKER

Business Name

JACK PENROD WHITAKER MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/25/2024