NICOLE ELIZABETH LARSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074270

License Status

EXPIRED

Business

Title

First Name

NICOLE

Middle

ELIZABETH

Last Name

LARSEN

Business Name

NICOLE ELIZABETH LARSEN MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022