MARY B FAUSONE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072112

License Status

NOT RENEWED

Business

First Name

MARY B

Last Name

FAUSONE

Suffix

Business Name

MARY B FAUSONE MD

Original Issue Date

12/06/1985

Effective Date

06/16/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023