RICHARD JOSEPH FAGAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076955

License Status

EXPIRED

Business

Title

First Name

RICHARD

Middle

JOSEPH

Last Name

FAGAN

Business Name

RICHARD JOSEPH FAGAN MD

Original Issue Date

06/25/2020

Effective Date

06/25/2020

Expiration Date

06/24/2021

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

10/11/2022