PIAVE P LAKE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035775

License Status

EXPIRED

Business

First Name

PIAVE

Middle

Last Name

LAKE

Business Name

PIAVE P LAKE

Original Issue Date

05/05/1997

Effective Date

05/05/1997

Expiration Date

06/16/2001

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/09/2022