JACKIE COHEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

JACKIE

Last Name

COHEN

Business Name

JACKIE COHEN

Original Issue Date

06/23/2003

Effective Date

06/23/2003

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60660

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011