CAMILLA Z LARSEN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

CAMILLA

Middle

Last Name

LARSEN

Business Name

CAMILLA Z LARSEN

Original Issue Date

03/15/2004

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/20/2023