CHARLI ATHENA T MELLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070689

License Status

CANCELLED

Business

Title

First Name

CHARLI ATHENA

Middle

Last Name

MELLA

Business Name

CHARLI ATHENA T MELLA MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/22/2017