KRISTEN M ZELLER HACK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103985

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

Last Name

ZELLER HACK

Business Name

KRISTEN M ZELLER HACK

Original Issue Date

01/04/2001

Effective Date

01/04/2001

Expiration Date

07/31/2005

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006