DANIEL FANTUS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140853

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Last Name

FANTUS

Business Name

DANIEL FANTUS MD

Original Issue Date

06/08/2016

Effective Date

06/08/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017