TAMARA FATIANOV Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037756

License Status

EXPIRED

Business

First Name

TAMARA

Last Name

FATIANOV

Business Name

TAMARA FATIANOV

Original Issue Date

05/15/1998

Effective Date

05/15/1998

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006