FABIO EDGARD SU MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031627

License Status

EXPIRED

Business

First Name

FABIO EDGARD

Last Name

Suffix

Business Name

FABIO EDGARD SU MD

Original Issue Date

06/01/1994

Effective Date

06/01/1994

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006