ALYSSA KAHAN FARGOTSTEIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072245

License Status

CANCELLED

Business

Title

First Name

ALYSSA

Middle

KAHAN

Last Name

FARGOTSTEIN

Business Name

ALYSSA KAHAN FARGOTSTEIN MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

04/19/2018