CAROLYN KELLY LAGATTUTA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071306

License Status

CANCELLED

Business

Title

First Name

CAROLYN

Middle

KELLY

Last Name

LAGATTUTA

Prefix

Business Name

CAROLYN KELLY LAGATTUTA DO

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/10/2017