FREDERIC MARK ETTNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

First Name

FREDERIC MARK

Last Name

ETTNER

Suffix

Business Name

FREDERIC MARK ETTNER MD

Original Issue Date

01/01/1997

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023