CHARLES JOSEPH FREDERICKS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063161

License Status

EXPIRED

Business

Title

First Name

CHARLES

Middle

JOSEPH

Last Name

FREDERICKS

Business Name

CHARLES JOSEPH FREDERICKS MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/02/2019