LATANIA KISA LOGAN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113313

License Status

ACTIVE

Business

First Name

LATANIA

Middle

KISA

Last Name

LOGAN

Business Name

LATANIA KISA LOGAN

Original Issue Date

03/22/2005

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/09/2023