MADONNA FABIAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064416

License Status

CANCELLED

Business

Title

First Name

MADONNA

Last Name

FABIAN

Business Name

MADONNA FABIAN MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/06/2014