ETHAN M CRUVANT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017377

License Status

EXPIRED

Business

First Name

ETHAN M

Last Name

CRUVANT

Suffix

Business Name

ETHAN M CRUVANT MD

Original Issue Date

06/26/1984

Effective Date

06/26/1984

Expiration Date

06/25/1986

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006