ALEXANDER FONDAW MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074844

License Status

CANCELLED

Business

Title

First Name

ALEXANDER

Last Name

FONDAW

Business Name

ALEXANDER FONDAW MD

Original Issue Date

06/25/2019

Effective Date

06/25/2019

Expiration Date

06/24/2022

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/11/2019