WAYNE MICHAEL LARSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067842

License Status

CANCELLED

Business

Title

First Name

WAYNE

Middle

MICHAEL

Last Name

LARSON

Business Name

WAYNE MICHAEL LARSON MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

06/24/2015