KIRSTEN AIMEE SORUM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057516

License Status

CANCELLED

Business

Title

First Name

KIRSTEN

Middle

AIMEE

Last Name

SORUM

Business Name

KIRSTEN AIMEE SORUM DO

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

OAK PARK

State

Zip

60302

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/30/2010