EARL E FREDRICK JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036305

License Status

NOT RENEWED

Business

First Name

EARL E

Last Name

FREDRICK JR

Suffix

Business Name

EARL E FREDRICK JR MD

Original Issue Date

11/25/1959

Effective Date

05/04/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021