KRISTEN LARA PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118520

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

LARA

Last Name

PARK

Suffix

Business Name

KRISTEN LARA PARK MD

Original Issue Date

05/29/2007

Effective Date

05/29/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008