CONCEPTA MAE V LASQUITE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

CONCEPTA MAE V

Last Name

LASQUITE

Suffix

Business Name

CONCEPTA MAE V LASQUITE MD

Original Issue Date

10/18/1991

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

ADDISON

State

Zip

60101

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021