JANE ELIZABETH LARSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055136

License Status

CANCELLED

Business

Title

First Name

JANE

Middle

ELIZABETH

Last Name

LARSEN

Business Name

JANE ELIZABETH LARSEN MD

Original Issue Date

06/25/2008

Effective Date

06/25/2008

Expiration Date

06/24/2011

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/27/2008