YELENA KISELEVA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075255

License Status

EXPIRED

Business

Title

First Name

YELENA

Last Name

KISELEVA

Business Name

YELENA KISELEVA DO

Original Issue Date

06/28/2019

Effective Date

06/28/2019

Expiration Date

06/27/2022

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022