ETHAN ANDERSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084125

License Status

ACTIVE

Business

Title

First Name

ETHAN

Last Name

ANDERSON

Business Name

ETHAN ANDERSON DO

Original Issue Date

06/25/2024

Effective Date

06/25/2024

Expiration Date

06/24/2027

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/25/2024