DANIELLE NICOLE LARSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065397

License Status

CANCELLED

Business

Title

First Name

DANIELLE

Middle

NICOLE

Last Name

LARSON

Business Name

DANIELLE NICOLE LARSON MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

04/05/2017