ETHAN JEROME MALTZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036171310

License Status

ACTIVE

Business

Title

First Name

ETHAN

Middle

JEROME

Last Name

MALTZ

Business Name

ETHAN JEROME MALTZ MD

Original Issue Date

07/26/2024

Effective Date

07/26/2024

Expiration Date

07/31/2026

City

DUNLAP

State

Zip

61525

Ever Disciplined

LastModifiedDate

07/10/2024