ELIZABETH CALISTA KERTOWIDJOJO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155653

License Status

ACTIVE

Business

Title

First Name

ELIZABETH

Middle

CALISTA

Last Name

KERTOWIDJOJO

Business Name

ELIZABETH CALISTA KERTOWIDJOJO MD

Original Issue Date

02/17/2021

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60653

Ever Disciplined

LastModifiedDate

01/30/2024