TODD ROBERT LARSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053668

License Status

CANCELLED

Business

Title

First Name

TODD

Middle

ROBERT

Last Name

LARSON

Business Name

TODD ROBERT LARSON DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

04/17/2008