JEFFREY DONALD LARSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060226

License Status

CANCELLED

Business

Title

First Name

JEFFREY

Middle

DONALD

Last Name

LARSON

Business Name

JEFFREY DONALD LARSON MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ADDISON

State

Zip

60101

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014