FREDERICK CONRAD EWALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038534

License Status

NOT RENEWED

Business

First Name

FREDERICK CONRAD

Last Name

EWALD

Suffix

Business Name

FREDERICK CONRAD EWALD MD

Original Issue Date

08/15/1963

Effective Date

08/15/1963

City

BOSTON

State

Zip

02120

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

09/20/2006