TIRSO MARK LARA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038273

License Status

EXPIRED

Business

First Name

TIRSO

Middle

MARK

Last Name

LARA

Suffix

Business Name

TIRSO MARK LARA MD

Original Issue Date

06/04/1998

Effective Date

06/04/1998

Expiration Date

06/28/2000

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006