BURT FAIBISOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062634

License Status

NOT RENEWED

Business

First Name

BURT

Last Name

FAIBISOFF

Suffix

Business Name

BURT FAIBISOFF MD

Original Issue Date

07/27/1981

Effective Date

07/27/1981

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

02/03/2007

Case Number

2005002982

Action

Refuse To Renew

Discipline Start Date

08/01/2005

Discipline Reason

DISCIPLINED IN ARIZONA.