ETHAN L GUNDECK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

ETHAN

Middle

Last Name

GUNDECK

Suffix

Business Name

ETHAN L GUNDECK MD

Original Issue Date

05/11/2001

Effective Date

05/11/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006