BROOKS T LASELLE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000696

License Status

EXPIRED

Business

First Name

BROOKS

Middle

Last Name

LASELLE

Suffix

Business Name

BROOKS T LASELLE MD

Original Issue Date

10/16/2006

Effective Date

10/16/2006

Expiration Date

11/15/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

01/26/2007