BEN W JAGODZINSKI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000680

License Status

EXPIRED

Business

First Name

BEN

Middle

Last Name

JAGODZINSKI

Business Name

BEN W JAGODZINSKI

Original Issue Date

06/05/2006

Effective Date

06/05/2006

Expiration Date

07/04/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/25/2006