ELIZABETH MARIE WOLLENSAK DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061119

License Status

CANCELLED

Business

Title

First Name

ELIZABETH

Middle

MARIE

Last Name

WOLLENSAK

Business Name

ELIZABETH MARIE WOLLENSAK DO

Original Issue Date

06/25/2012

Effective Date

06/25/2012

Expiration Date

06/24/2015

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/24/2014