KILIAN RUSSELL LAFRENIERE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001320

License Status

EXPIRED

Business

Title

First Name

KILIAN

Middle

RUSSELL

Last Name

LAFRENIERE

Business Name

KILIAN RUSSELL LAFRENIERE DO

Original Issue Date

11/25/2019

Effective Date

11/25/2019

Expiration Date

12/22/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

03/05/2020