JILL SUZANNE FREDERICK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000869

License Status

EXPIRED

Business

Title

First Name

JILL

Middle

SUZANNE

Last Name

FREDERICK

Business Name

JILL SUZANNE FREDERICK MD

Original Issue Date

08/01/2011

Effective Date

08/01/2011

Expiration Date

08/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Medical Genetics

Ever Disciplined

LastModifiedDate

09/30/2011