MARK ADRIAN FAASSE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051472

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

ADRIAN

Last Name

FAASSE

Business Name

MARK ADRIAN FAASSE MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

Pediatric Urology

Ever Disciplined

LastModifiedDate

05/02/2013