FABIAN ENRIQUE CARBONELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

FABIAN

Middle

ENRIQUE

Last Name

CARBONELL

Suffix

Business Name

FABIAN ENRIQUE CARBONELL MD

Original Issue Date

07/20/1998

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023