RENATA LARISSA KESALA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042248

License Status

EXPIRED

Business

First Name

RENATA

Middle

LARISSA

Last Name

KESALA

Suffix

Business Name

RENATA LARISSA KESALA DO

Original Issue Date

06/23/2001

Effective Date

06/23/2001

Expiration Date

06/22/2002

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006