LACEY MARIE ROME Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055713

License Status

EXPIRED

Business

First Name

LACEY

Middle

MARIE

Last Name

ROME

Business Name

LACEY MARIE ROME

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

08/29/2012