IAN J GOLDBERG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017910

License Status

EXPIRED

Business

First Name

IAN J

Last Name

GOLDBERG

Suffix

Business Name

IAN J GOLDBERG DO

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

07/01/1988

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006