TANIA STAVREVA BALABANOVA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055557

License Status

CANCELLED

Business

First Name

TANIA

Middle

STAVREVA

Last Name

BALABANOVA

Suffix

Business Name

TANIA STAVREVA BALABANOVA MD

Original Issue Date

08/04/2008

Effective Date

08/04/2008

Expiration Date

08/03/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

12/01/2011