HANI RUSTOM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077747

License Status

CANCELLED

Business

Title

First Name

HANI

Last Name

RUSTOM

Business Name

HANI RUSTOM DO

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/20/2021