RICHARD JACOB FANTUS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142681

License Status

NOT RENEWED

Business

Title

First Name

RICHARD

Middle

JACOB

Last Name

FANTUS

Business Name

RICHARD JACOB FANTUS MD

Original Issue Date

03/15/2017

Effective Date

04/21/2020

Expiration Date

07/31/2023

City

METTAWA

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

11/30/2023