GORDON L LARSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026140

License Status

EXPIRED

Business

First Name

GORDON L

Last Name

LARSEN

Suffix

Business Name

GORDON L LARSEN MD

Original Issue Date

04/12/1991

Effective Date

04/12/1991

Expiration Date

06/30/1994

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006