STEPHANIE MATHEWS KAZANTSEV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066883

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

MATHEWS

Last Name

KAZANTSEV

Business Name

STEPHANIE MATHEWS KAZANTSEV MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

05/17/2018