JACK A DUSTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

JACK A

Last Name

DUSTIN

Suffix

Business Name

JACK A DUSTIN MD

Original Issue Date

01/01/1997

Effective Date

06/08/2017

Expiration Date

09/30/2020

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021