SUSAN MICHELLE FANAPOUR DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105985

License Status

ACTIVE

Business

First Name

SUSAN

Middle

MICHELLE

Last Name

FANAPOUR

Suffix

Business Name

SUSAN MICHELLE FANAPOUR DO

Original Issue Date

12/14/2001

Effective Date

05/08/2023

Expiration Date

07/31/2026

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/08/2023