LARISSA N BERESTENKO - Medical Doctor License in Illinois | # 125037232

LARISSA N BERESTENKO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037232

License Status

EXPIRED

Business

N

First Name

LARISSA

Middle

N

Last Name

BERESTENKO

Business Name

LARISSA N BERESTENKO

Original Issue Date

01/01/1997

Effective Date

01/01/1997

Expiration Date

10/02/2000

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006