REBECCA JEAN LARSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054853

License Status

EXPIRED

Business

Title

First Name

REBECCA

Middle

JEAN

Last Name

LARSON

Business Name

REBECCA JEAN LARSON MD

Original Issue Date

06/26/2011

Effective Date

06/26/2011

Expiration Date

06/25/2012

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

08/29/2012