EDMOND GHAHRAMANIDIZAJTAKIEH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048332

License Status

EXPIRED

Business

First Name

EDMOND

Last Name

GHAHRAMANIDIZAJTAKIEH

Suffix

Business Name

EDMOND GHAHRAMANIDIZAJTAKIEH MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007