NATHAN MATTHEW LEBAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046155

License Status

EXPIRED

Business

First Name

NATHAN

Middle

MATTHEW

Last Name

LEBAK

Suffix

Business Name

NATHAN MATTHEW LEBAK MD

Original Issue Date

06/16/2003

Effective Date

06/16/2003

Expiration Date

06/15/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006