BOURTAI KANDAHAR GOLD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075161

License Status

EXPIRED

Business

Title

First Name

BOURTAI

Middle

KANDAHAR

Last Name

GOLD

Business Name

BOURTAI KANDAHAR GOLD DO

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2024

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

10/30/2024