JOHN THOMAS FREDERICK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

CANCELLED

Business

First Name

JOHN

Middle

THOMAS

Last Name

FREDERICK

Suffix

Business Name

JOHN THOMAS FREDERICK MD

Original Issue Date

05/23/2000

Effective Date

05/23/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006