STACEY A MONDINO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041070

License Status

EXPIRED

Business

First Name

STACEY

Middle

Last Name

MONDINO

Suffix

Business Name

STACEY A MONDINO MD

Original Issue Date

06/23/2000

Effective Date

06/23/2000

Expiration Date

06/22/2001

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006