MITSUO FUWA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046134

License Status

NOT RENEWED

Business

First Name

MITSUO

Last Name

FUWA

Suffix

Business Name

MITSUO FUWA MD

Original Issue Date

08/17/1972

Effective Date

07/15/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011