JARED BLAINE HOSSACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

JARED

Middle

BLAINE

Last Name

HOSSACK

Suffix

Business Name

JARED BLAINE HOSSACK MD

Original Issue Date

05/01/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011