STACI LYNN VANDERJACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

ACTIVE

Business

Title

First Name

STACI

Middle

LYNN

Last Name

VANDERJACK

Business Name

STACI LYNN VANDERJACK MD

Original Issue Date

08/28/2014

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023