MICHAEL ALAN MASTELLER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063645

License Status

CANCELLED

Business

Title

First Name

MICHAEL

Middle

ALAN

Last Name

MASTELLER

Business Name

MICHAEL ALAN MASTELLER MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/24/2014