STASIA DIANA ROUSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146466

License Status

ACTIVE

Business

Title

First Name

STASIA

Middle

DIANA

Last Name

ROUSE

Business Name

STASIA DIANA ROUSE MD

Original Issue Date

06/19/2018

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

07/26/2023