MARK R NEUSTROM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023065

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

NEUSTROM

Business Name

MARK R NEUSTROM

Original Issue Date

07/20/1988

Effective Date

07/20/1988

Expiration Date

09/01/1991

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006