JONATHAN MARK FANAROFF MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037983

License Status

EXPIRED

Business

First Name

JONATHAN

Middle

MARK

Last Name

FANAROFF

Suffix

Business Name

JONATHAN MARK FANAROFF MD

Original Issue Date

05/26/1998

Effective Date

05/26/1998

Expiration Date

06/15/2001

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006