NISSIM GEDALIAH STOLBERG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067054

License Status

EXPIRED

Business

Title

First Name

NISSIM

Middle

GEDALIAH

Last Name

STOLBERG

Business Name

NISSIM GEDALIAH STOLBERG DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/25/2018