ETHAN M CRUVANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036071768

License Status

NOT RENEWED

Business

First Name

ETHAN M

Last Name

CRUVANT

Suffix

Business Name

ETHAN M CRUVANT MD

Original Issue Date

09/27/1985

Effective Date

09/27/1985

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006