SHEILA BALLINTINE GUSSAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062656

License Status

CANCELLED

Business

Title

First Name

SHEILA

Middle

BALLINTINE

Last Name

GUSSAK

Business Name

SHEILA BALLINTINE GUSSAK MD

Original Issue Date

06/23/2013

Effective Date

06/23/2013

Expiration Date

06/22/2016

City

CHICAGO

State

Zip

60604

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014