MICHAEL B FAGAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

MICHAEL B

Last Name

FAGAN

Suffix

DDS

Business Name

MICHAEL B FAGAN DDS

Original Issue Date

01/01/1998

Effective Date

10/22/2021

Expiration Date

09/30/2024

City

FRANKFORT

State

Zip

60423

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025