MARISSA JANE VERSALLE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146901

License Status

ACTIVE

Business

Title

First Name

MARISSA

Middle

JANE

Last Name

VERSALLE

Business Name

MARISSA JANE VERSALLE DO

Original Issue Date

07/12/2018

Effective Date

05/14/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

COOK

Ever Disciplined

LastModifiedDate

05/14/2023