JENNIFER M FERGESTAD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000633

License Status

EXPIRED

Business

First Name

JENNIFER

Middle

Last Name

FERGESTAD

Business Name

JENNIFER M FERGESTAD

Original Issue Date

05/02/2005

Effective Date

05/02/2005

Expiration Date

06/01/2005

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/25/2006