POJ LYSOUVAKON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034818

License Status

EXPIRED

Business

First Name

POJ

Last Name

LYSOUVAKON

Business Name

POJ LYSOUVAKON

Original Issue Date

06/03/1996

Effective Date

06/03/1996

Expiration Date

06/23/1999

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006