LARISSA KOULIEVA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036964

License Status

EXPIRED

Business

First Name

LARISSA

Last Name

KOULIEVA

Business Name

LARISSA KOULIEVA

Original Issue Date

06/26/1997

Effective Date

06/26/1997

Expiration Date

06/25/1998

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006