JASON J LARSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108327

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

LARSON

Business Name

JASON J LARSON

Original Issue Date

12/20/2002

Effective Date

12/20/2002

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006