KAROLINA STACK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070693

License Status

CANCELLED

Business

Title

First Name

KAROLINA

Last Name

STACK

Business Name

KAROLINA STACK MD

Original Issue Date

06/22/2017

Effective Date

06/22/2017

Expiration Date

06/21/2020

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/11/2017