JACK A DUSTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

JACK A

Last Name

DUSTIN

Suffix

Business Name

JACK A DUSTIN MD

Original Issue Date

09/24/1990

Effective Date

09/24/1990

Expiration Date

07/31/1993

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020