DAVID J WALLENSTEIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036623

License Status

EXPIRED

Business

First Name

DAVID J

Last Name

WALLENSTEIN

Business Name

DAVID J WALLENSTEIN

Original Issue Date

06/11/1997

Effective Date

06/11/1997

Expiration Date

06/28/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006