DMITRY BALIAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075300

License Status

EXPIRED

Business

Title

First Name

DMITRY

Last Name

BALIAN

Business Name

DMITRY BALIAN MD

Original Issue Date

08/09/2019

Effective Date

08/09/2019

Expiration Date

08/08/2020

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

11/19/2020