DANIEL P FAGIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

First Name

DANIEL

Middle

Last Name

FAGIN

Suffix

Business Name

DANIEL P FAGIN MD

Original Issue Date

05/02/2008

Effective Date

05/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/15/2023