SAMUEL IVAN BARONOFSKY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035144

License Status

EXPIRED

Business

First Name

SAMUEL IVAN

Last Name

BARONOFSKY

Business Name

SAMUEL IVAN BARONOFSKY

Original Issue Date

06/17/1996

Effective Date

06/17/1996

Expiration Date

06/30/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006