LARISSA N BERESTENKO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037232

License Status

EXPIRED

Business

First Name

LARISSA

Middle

Last Name

BERESTENKO

Business Name

LARISSA N BERESTENKO

Original Issue Date

01/01/1997

Effective Date

01/01/1997

Expiration Date

10/02/2000

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006