ALEXANDER FEOKTISTOV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053664

License Status

CANCELLED

Business

Title

First Name

ALEXANDER

Last Name

FEOKTISTOV

Business Name

ALEXANDER FEOKTISTOV MD

Original Issue Date

06/20/2007

Effective Date

06/20/2007

Expiration Date

06/19/2010

City

NORTHFIELD

State

Zip

60093

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/11/2007