ILJA FAIBUSSOWITSCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

First Name

ILJA

Last Name

FAIBUSSOWITSCH

Suffix

Business Name

ILJA FAIBUSSOWITSCH MD

Original Issue Date

01/23/1997

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

DES PLAINES

State

Zip

60016

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023