PHILIP CYRUS FANAPOUR DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060278

License Status

EXPIRED

Business

Title

First Name

PHILIP

Middle

CYRUS

Last Name

FANAPOUR

Business Name

PHILIP CYRUS FANAPOUR DO

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

NORTH CHICAGO

State

Zip

60064

Specialty/Qualifier

Rotating Internship

Ever Disciplined

LastModifiedDate

08/29/2012