MEHRDAD EATESAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069163

License Status

CANCELLED

Business

Title

First Name

MEHRDAD

Last Name

EATESAM

Business Name

MEHRDAD EATESAM MD

Original Issue Date

06/20/2016

Effective Date

06/20/2016

Expiration Date

06/19/2019

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/31/2018