JILL A ODENTHAL SRACIC MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134528

License Status

NOT RENEWED

Business

Title

First Name

JILL A

Middle

ODENTHAL

Last Name

SRACIC

Business Name

JILL A ODENTHAL SRACIC MD

Original Issue Date

01/31/2014

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

WAUWATOSA

State

Zip

53213

County

LAKE

Ever Disciplined

LastModifiedDate

01/14/2021