LESLIE R FAROLAN 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

LESLIE R

Last Name

FAROLAN

Suffix

Business Name

LESLIE R FAROLAN MD

Original Issue Date

11/14/1991

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023