KURT A MELSTROM JR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045840

License Status

EXPIRED

Business

First Name

KURT

Middle

Last Name

MELSTROM JR

Business Name

KURT A MELSTROM JR

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006