NICOLAS LARA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074068

License Status

EXPIRED

Business

Title

First Name

NICOLAS

Last Name

LARA

Business Name

NICOLAS LARA MD

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2020

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

11/19/2020