MICHELLE JOLIE CHASTAIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057868

License Status

CANCELLED

Business

Title

First Name

MICHELLE

Middle

JOLIE

Last Name

CHASTAIN

Business Name

MICHELLE JOLIE CHASTAIN MD

Original Issue Date

06/28/2010

Effective Date

06/28/2010

Expiration Date

06/27/2013

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/26/2010