FRANKLIN MORAL BANZALI JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045754

License Status

CANCELLED

Business

First Name

FRANKLIN

Middle

MORAL

Last Name

BANZALI

Suffix

JR MD

Business Name

FRANKLIN MORAL BANZALI JR MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2006

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006