JILL SUSANNE BJORGE NELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

JILL SUSANNE

Middle

BJORGE

Last Name

NELSON

Suffix

Business Name

JILL SUSANNE BJORGE NELSON MD

Original Issue Date

04/18/2002

Effective Date

04/18/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006