PAUL WAYNE FRUTOS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108045

License Status

NOT RENEWED

Business

First Name

PAUL

Middle

WAYNE

Last Name

FRUTOS

Suffix

Business Name

PAUL WAYNE FRUTOS DO

Original Issue Date

10/21/2002

Effective Date

10/21/2002

Expiration Date

07/31/2005

City

RIVER FOREST

State

Zip

60305

County

COOK

Ever Disciplined

LastModifiedDate

12/11/2012