ERIK JOHN FOSSEN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069652

License Status

CANCELLED

Business

Title

First Name

ERIK

Middle

JOHN

Last Name

FOSSEN

Business Name

ERIK JOHN FOSSEN DO

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

PARKRIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/28/2016