LALEH MELSTROM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045616

License Status

EXPIRED

Business

First Name

LALEH

Last Name

MELSTROM

Suffix

Business Name

LALEH MELSTROM MD

Original Issue Date

06/17/2003

Effective Date

06/17/2003

Expiration Date

06/16/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006