TRISTAN LEOPOLD PASEK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069368

License Status

CANCELLED

Business

Title

First Name

TRISTAN

Middle

LEOPOLD

Last Name

PASEK

Business Name

TRISTAN LEOPOLD PASEK MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/13/2016