STANFORD EDWIN MERMELSTEIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058844

License Status

NOT RENEWED

Business

First Name

STANFORD EDWIN

Last Name

MERMELSTEIN

Suffix

Business Name

STANFORD EDWIN MERMELSTEIN MD

Original Issue Date

07/12/1979

Effective Date

07/12/1979

Expiration Date

07/01/1982

City

CHAMPAIGN

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/20/2006