JEREMY A LACOCQUE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066599

License Status

CANCELLED

Business

Title

First Name

JEREMY

Middle

Last Name

LACOCQUE

Business Name

JEREMY A LACOCQUE DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/18/2015