JENNINE L LARSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036116068

License Status

NOT RENEWED

Business

First Name

JENNINE

Middle

Last Name

LARSON

Business Name

JENNINE L LARSON

Original Issue Date

06/01/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/14/2011