JORDAN DALE WAXMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

JORDAN DALE

Last Name

WAXMAN

Suffix

Business Name

JORDAN DALE WAXMAN MD

Original Issue Date

11/23/1981

Effective Date

04/27/2011

Expiration Date

07/31/2014

City

WILMETTE

State

Zip

60091

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014