JUAN M LASA JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

CANCELLED

Business

Title

First Name

JUAN

Middle

Last Name

LASA

Suffix

Business Name

JUAN M LASA JR MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008