PHILIP VASIN BYSTROM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074072

License Status

CANCELLED

Business

Title

First Name

PHILIP

Middle

VASIN

Last Name

BYSTROM

Business Name

PHILIP VASIN BYSTROM MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/31/2022