GUSTAVO ADOLFO LAGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036031697

License Status

NOT RENEWED

Business

First Name

GUSTAVO ADOLFO

Last Name

LAGE

Suffix

Business Name

GUSTAVO ADOLFO LAGE MD

Original Issue Date

11/28/1952

Effective Date

11/28/1952

Expiration Date

07/01/1982

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006