FREDERICK STEVEN FANAPOUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

FREDERICK STEVEN

Last Name

FANAPOUR

Suffix

Business Name

FREDERICK STEVEN FANAPOUR MD

Original Issue Date

09/25/1996

Effective Date

09/25/1996

Expiration Date

07/31/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017