SHADI LATTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050777

License Status

CANCELLED

Business

First Name

SHADI

Last Name

LATTA

Suffix

Business Name

SHADI LATTA MD

Original Issue Date

06/21/2006

Effective Date

06/21/2006

Expiration Date

06/20/2009

City

WILLOWBROOK

State

Zip

60527

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006