JACK RONALD PICKLEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

JACK RONALD

Last Name

PICKLEMAN

Suffix

Business Name

JACK RONALD PICKLEMAN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006