JUSTIN M GOLDFARB DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047282

License Status

CANCELLED

Business

First Name

JUSTIN

Middle

Last Name

GOLDFARB

Suffix

Business Name

JUSTIN M GOLDFARB DO

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60610

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006