RYAN PATRICK STORK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067804

License Status

EXPIRED

Business

Title

First Name

RYAN

Middle

PATRICK

Last Name

STORK

Business Name

RYAN PATRICK STORK MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Brain Injury Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

08/16/2016