JESSE CARL LAVIN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062947

License Status

CANCELLED

Business

Title

First Name

JESSE

Middle

CARL

Last Name

LAVIN

Business Name

JESSE CARL LAVIN DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/24/2014