GASTON OCTAVIO LACAYO III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

GASTON

Middle

OCTAVIO

Last Name

LACAYO

Suffix

III MD

Business Name

GASTON OCTAVIO LACAYO III MD

Original Issue Date

03/13/2006

Effective Date

07/28/2011

Expiration Date

07/31/2014

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014