DEREK SLOAN LARSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054269

License Status

CANCELLED

Business

Title

First Name

DEREK

Middle

SLOAN

Last Name

LARSON

Business Name

DEREK SLOAN LARSON MD

Original Issue Date

06/30/2009

Effective Date

06/30/2009

Expiration Date

06/29/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/12/2009