ETHAN LEWIS SEGAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058541

License Status

CANCELLED

Business

Title

First Name

ETHAN

Middle

LEWIS

Last Name

SEGAL

Business Name

ETHAN LEWIS SEGAL MD

Original Issue Date

06/22/2010

Effective Date

06/22/2010

Expiration Date

06/21/2013

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

04/26/2010