EUGENE TARASOV DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059802

License Status

CANCELLED

Business

Title

First Name

EUGENE

Last Name

TARASOV

Business Name

EUGENE TARASOV DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2016

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/28/2014