JUSTIN MATTHEW LIST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158455

License Status

ACTIVE

Business

Title

First Name

JUSTIN

Middle

MATTHEW

Last Name

LIST

Business Name

JUSTIN MATTHEW LIST MD

Original Issue Date

10/06/2021

Effective Date

08/25/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

Ever Disciplined

LastModifiedDate

08/25/2023