JAN E LEESTMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

JAN E

Last Name

LEESTMA

Suffix

Business Name

JAN E LEESTMA MD

Original Issue Date

08/19/2014

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60606

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021