JOHNATHAN BEAU LILJENQUIST DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001408

License Status

EXPIRED

Business

Title

First Name

JOHNATHAN

Middle

BEAU

Last Name

LILJENQUIST

Business Name

JOHNATHAN BEAU LILJENQUIST DO

Original Issue Date

08/16/2021

Effective Date

08/16/2021

Expiration Date

09/15/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

10/11/2022