PIA B LISLE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046289

License Status

EXPIRED

Business

First Name

PIA

Middle

Last Name

LISLE

Business Name

PIA B LISLE

Original Issue Date

06/16/2003

Effective Date

06/16/2003

Expiration Date

06/15/2006

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006