LAURA ANNE DOUGLASS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057098

License Status

CANCELLED

Business

Title

First Name

LAURA

Middle

ANNE

Last Name

DOUGLASS

Business Name

LAURA ANNE DOUGLASS MD

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2012

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

04/28/2009