BRETT A LAVEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039128

License Status

EXPIRED

Business

First Name

BRETT

Middle

Last Name

LAVEN

Business Name

BRETT A LAVEN

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

06/23/2005

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006