NATALIE ROMA KOZLOV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051411

License Status

CANCELLED

Business

First Name

NATALIE

Middle

ROMA

Last Name

KOZLOV

Suffix

Business Name

NATALIE ROMA KOZLOV MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2010

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/08/2010