JUAN M LASA JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058108

License Status

INACTIVE

Business

Title

First Name

JUAN

Middle

Last Name

LASA

Suffix

Business Name

JUAN M LASA JR MD

Original Issue Date

11/20/1978

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60646

County

COOK

Ever Disciplined

LastModifiedDate

04/17/2008