MARIOLA MJALTAJ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

Title

First Name

MARIOLA

Last Name

MJALTAJ

Business Name

MARIOLA MJALTAJ MD

Original Issue Date

07/20/2012

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021