ELIZABETH NORD FAHRENBACH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056349

License Status

CANCELLED

Business

Title

First Name

ELIZABETH

Middle

NORD

Last Name

FAHRENBACH

Business Name

ELIZABETH NORD FAHRENBACH MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

NILES

State

Zip

60714

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

04/20/2012