EDWARD D FREDERICKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063600

License Status

NOT RENEWED

Business

First Name

EDWARD D

Last Name

FREDERICKSON

Suffix

Business Name

EDWARD D FREDERICKSON MD

Original Issue Date

12/03/1981

Effective Date

12/03/1981

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60011

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006