MARK JOHN STOLTENBERG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062417

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

JOHN

Last Name

STOLTENBERG

Business Name

MARK JOHN STOLTENBERG MD

Original Issue Date

07/09/2012

Effective Date

07/09/2012

Expiration Date

07/08/2015

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014