MITHILA FADIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

Title

First Name

MITHILA

Last Name

FADIA

Business Name

MITHILA FADIA MD

Original Issue Date

09/11/2019

Effective Date

09/22/2020

Expiration Date

07/31/2023

City

LAKE FOREST

State

Zip

60045

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023