STEFAN MICHAEL BUMOL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064395

License Status

CANCELLED

Business

Title

First Name

STEFAN

Middle

MICHAEL

Last Name

BUMOL

Business Name

STEFAN MICHAEL BUMOL MD

Original Issue Date

06/24/2014

Effective Date

06/24/2014

Expiration Date

06/23/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

04/30/2014