MARK E FRUIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017528

License Status

EXPIRED

Business

First Name

MARK E

Last Name

FRUIN

Suffix

Business Name

MARK E FRUIN MD

Original Issue Date

07/17/1984

Effective Date

07/17/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006