JEREMIAH JERRY PARK DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****82

NOT RENEWED

N

JEREMIAH JERRY

PARK

DO

JEREMIAH JERRY PARK DO

08/19/1982

08/19/1982

07/31/2002

VERNON HILLS

IL

60061

LAKE

II III IV V

Y

10/09/2006

1994004400

Reprimand

12/11/1997