LALEH MELSTROM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114503

License Status

INACTIVE

Business

First Name

LALEH

Last Name

MELSTROM

Suffix

Business Name

LALEH MELSTROM MD

Original Issue Date

08/29/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

03/29/2012