MATTHEW DAVID ETTLESON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148504

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

DAVID

Last Name

ETTLESON

Business Name

MATTHEW DAVID ETTLESON MD

Original Issue Date

03/11/2019

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

Ever Disciplined

LastModifiedDate

04/08/2023