ATHENA KOSTIDIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042890

License Status

CANCELLED

Business

First Name

ATHENA

Last Name

KOSTIDIS

Suffix

Business Name

ATHENA KOSTIDIS MD

Original Issue Date

06/28/2001

Effective Date

06/28/2001

Expiration Date

06/27/2002

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006