STEPHENIE MARIE TAKAHASHI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051782

License Status

CANCELLED

Business

First Name

STEPHENIE

Middle

MARIE

Last Name

TAKAHASHI

Suffix

Business Name

STEPHENIE MARIE TAKAHASHI MD

Original Issue Date

06/24/2006

Effective Date

06/24/2006

Expiration Date

06/23/2009

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006