RAELENE H LARSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072905

License Status

NOT RENEWED

Business

First Name

RAELENE H

Last Name

LARSON

Suffix

Business Name

RAELENE H LARSON MD

Original Issue Date

06/12/1986

Effective Date

06/12/1986

Expiration Date

07/31/1990

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/20/2006