EKATERINA BAZUNOVA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086035

License Status

ACTIVE

Business

Title

First Name

EKATERINA

Last Name

BAZUNOVA

Business Name

EKATERINA BAZUNOVA MD

Original Issue Date

06/22/2025

Effective Date

06/22/2025

Expiration Date

06/21/2028

City

BERWYN

State

Zip

60402

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/29/2025