FREDERICK STEVEN FANAPOUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

FREDERICK STEVEN

Last Name

FANAPOUR

Suffix

Business Name

FREDERICK STEVEN FANAPOUR MD

Original Issue Date

05/19/1997

Effective Date

04/17/2014

Expiration Date

07/31/2017

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017