STACY M LAURENT DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061540

License Status

CANCELLED

Business

Title

First Name

STACY

Middle

Last Name

LAURENT

Business Name

STACY M LAURENT DO

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/24/2014