DOUGLAS JACKSON FIFE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

JACKSON

Last Name

FIFE

Suffix

Business Name

DOUGLAS JACKSON FIFE MD

Original Issue Date

05/21/2008

Effective Date

05/21/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

04/05/2020