MITRA FARAHATI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058093

License Status

NOT RENEWED

Business

First Name

MITRA

Last Name

FARAHATI

Suffix

Business Name

MITRA FARAHATI MD

Original Issue Date

11/20/1978

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

WILMETTE

State

Zip

60091

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014