RICHARD LEE JENSEN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

CANCELLED

Business

First Name

RICHARD LEE

Last Name

JENSEN

Suffix

Business Name

RICHARD LEE JENSEN DO

Original Issue Date

01/01/1997

Effective Date

07/11/2011

Expiration Date

07/31/2014

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014