LACEY LEA KRUSE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055766

License Status

EXPIRED

Business

Title

First Name

LACEY

Middle

LEA

Last Name

KRUSE

Business Name

LACEY LEA KRUSE MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

Pediatric Dermatology

Ever Disciplined

LastModifiedDate

03/13/2015