DAVID FAVREAU FARDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118859

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

FAVREAU

Last Name

FARDON

Suffix

Business Name

DAVID FAVREAU FARDON MD

Original Issue Date

06/29/2007

Effective Date

06/16/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023