FREDERIC MARK ETTNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

FREDERIC MARK

Last Name

ETTNER

Suffix

Business Name

FREDERIC MARK ETTNER MD

Original Issue Date

11/08/2013

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

GLENVIEW

State

Zip

60026

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020