LESLIE R FAROLAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022700

License Status

EXPIRED

Business

First Name

LESLIE R

Last Name

FAROLAN

Suffix

Business Name

LESLIE R FAROLAN MD

Original Issue Date

06/07/1988

Effective Date

06/07/1988

Expiration Date

07/01/1991

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006