MEGAN RENEE FUQUA 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

Title

First Name

MEGAN

Middle

RENEE

Last Name

FUQUA

Business Name

MEGAN RENEE FUQUA MD

Original Issue Date

05/05/2020

Effective Date

05/05/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023