ELIE R CRYSTAL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071286

License Status

CANCELLED

Business

Title

First Name

ELIE

Middle

Last Name

CRYSTAL

Business Name

ELIE R CRYSTAL DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/13/2017