EDEN LOUISE PAPPO LAKE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062828

License Status

CANCELLED

Business

Title

First Name

EDEN

Middle

LOUISE PAPPO

Last Name

LAKE

Business Name

EDEN LOUISE PAPPO LAKE MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

05/26/2016