FABIAN REVITA FRANCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094215

License Status

NOT RENEWED

Business

First Name

FABIAN REVITA

Last Name

FRANCO

Suffix

Business Name

FABIAN REVITA FRANCO MD

Original Issue Date

09/14/1996

Effective Date

09/14/1996

Expiration Date

07/31/2002

City

BRIDGEVEW

State

Zip

60455

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006