JASON P GONSKY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

GONSKY

Business Name

JASON P GONSKY

Original Issue Date

06/17/2004

Effective Date

06/17/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006