AMALIJA N FAIRBANKS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069629

License Status

INACTIVE

Business

First Name

AMALIJA N

Last Name

FAIRBANKS

Suffix

Business Name

AMALIJA N FAIRBANKS MD

Original Issue Date

10/15/1984

Effective Date

10/15/1984

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006