EDMAR M LACAY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053230

License Status

CANCELLED

Business

First Name

EDMAR

Middle

Last Name

LACAY

Suffix

Business Name

EDMAR M LACAY MD

Original Issue Date

06/25/2007

Effective Date

06/25/2007

Expiration Date

06/24/2010

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/31/2007