JENIFER A LARSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

JENIFER

Middle

Last Name

LARSEN

Suffix

Business Name

JENIFER A LARSEN MD

Original Issue Date

06/18/1998

Effective Date

06/18/1998

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006