LANE MARIE LAGATTUTA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072770

License Status

CANCELLED

Business

Title

First Name

LANE

Middle

MARIE

Last Name

LAGATTUTA

Business Name

LANE MARIE LAGATTUTA DO

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

04/05/2021