JUAN M LASA JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

Title

First Name

JUAN

Middle

Last Name

LASA

Suffix

Business Name

JUAN M LASA JR MD

Original Issue Date

05/15/1992

Effective Date

05/15/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60652

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006