AUSTIN FAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074936

License Status

EXPIRED

Business

Title

First Name

AUSTIN

Last Name

FAN

Business Name

AUSTIN FAN MD

Original Issue Date

06/22/2019

Effective Date

06/22/2019

Expiration Date

06/21/2022

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022