MICAH JAMES LEESTMA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059138

License Status

EXPIRED

Business

First Name

MICAH

Middle

JAMES

Last Name

LEESTMA

Business Name

MICAH JAMES LEESTMA

Original Issue Date

06/10/2011

Effective Date

06/10/2011

Expiration Date

06/09/2014

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015