FAIRBANK T CHUA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058983

License Status

NOT RENEWED

Business

First Name

FAIRBANK T

Last Name

CHUA

Business Name

FAIRBANK T CHUA

Original Issue Date

07/20/1979

Effective Date

07/20/1979

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006

Case Number

1983000185

Action

Probation

Discipline Start Date

11/05/1987

Discipline End Date

11/05/1988