EGIL FOSSLIEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045209

License Status

NOT RENEWED

Business

First Name

EGIL

Last Name

FOSSLIEN

Suffix

Business Name

EGIL FOSSLIEN MD

Original Issue Date

02/04/1972

Effective Date

06/02/2014

Expiration Date

07/31/2017

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017