JOHN FIKRY MITYAS IBRAHIM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069705

License Status

CANCELLED

Business

Title

First Name

JOHN

Middle

FIKRY MITYAS

Last Name

IBRAHIM

Business Name

JOHN FIKRY MITYAS IBRAHIM MD

Original Issue Date

08/15/2016

Effective Date

08/15/2016

Expiration Date

08/14/2019

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/03/2016