DAVID L FAY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

DAVID L

Last Name

FAY

Suffix

Business Name

DAVID L FAY MD

Original Issue Date

06/23/1997

Effective Date

06/23/1997

Expiration Date

07/31/2002

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006