ELIZABETH A FAGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

ELIZABETH A

Last Name

FAGAN

Suffix

Business Name

ELIZABETH A FAGAN MD

Original Issue Date

12/03/1996

Effective Date

12/03/1996

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/05/2020