SHAHLA ALYSE BOLBOLAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046316

License Status

EXPIRED

Business

First Name

SHAHLA

Middle

ALYSE

Last Name

BOLBOLAN

Suffix

Business Name

SHAHLA ALYSE BOLBOLAN MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006