LAURA FASULO ROSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122812

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

FASULO

Last Name

ROSS

Suffix

Business Name

LAURA FASULO ROSS MD

Original Issue Date

03/10/2009

Effective Date

03/10/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011