LAKE STREET FAMILY PHYSICIANS SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042618366

License Status

NOT RENEWED

Business

Business Name

LAKE STREET FAMILY PHYSICIANS SC

Original Issue Date

11/03/2004

Effective Date

11/29/2018

Expiration Date

01/01/2022

City

OAK PARK

State

Zip

60301

County

COOK

Ever Disciplined

LastModifiedDate

02/15/2023