URSINA R TEITELBAUM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106630

License Status

NOT RENEWED

Business

First Name

URSINA

Middle

Last Name

TEITELBAUM

Business Name

URSINA R TEITELBAUM

Original Issue Date

03/29/2002

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008