STACI LYNN BOLDIZSAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058176

License Status

CANCELLED

Business

Title

First Name

STACI

Middle

LYNN

Last Name

BOLDIZSAR

Business Name

STACI LYNN BOLDIZSAR MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2015

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

Clinical Neurophysiology

Ever Disciplined

LastModifiedDate

04/04/2014