TRISTAN ANTHONY PONZO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083534

License Status

ACTIVE

Business

Title

First Name

TRISTAN

Middle

ANTHONY

Last Name

PONZO

Business Name

TRISTAN ANTHONY PONZO MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

06/09/2025