MIRIAM M BALTUANO SONGHURST MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068136

License Status

CANCELLED

Business

Title

First Name

MIRIAM

Middle

Last Name

BALTUANO SONGHURST

Business Name

MIRIAM M BALTUANO SONGHURST MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Child Neurology

Ever Disciplined

LastModifiedDate

03/05/2019