PAUL WAYNE FRUTOS DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040750

License Status

EXPIRED

Business

First Name

PAUL

Middle

WAYNE

Last Name

FRUTOS

Suffix

Business Name

PAUL WAYNE FRUTOS DO

Original Issue Date

06/22/2000

Effective Date

06/22/2000

Expiration Date

06/21/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006