WAYNE MICHAEL LARSON MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****78

NOT RENEWED

N

MD

WAYNE

MICHAEL

LARSON

WAYNE MICHAEL LARSON MD

07/09/2018

09/28/2020

07/31/2023

CHICAGO

IL

60640

COOK

PRACTITIONER

II III IV V

N

11/30/2023