GRACE WILLERT FAULKNER 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

Title

First Name

GRACE

Last Name

WILLERT FAULKNER

Business Name

GRACE WILLERT FAULKNER MD

Original Issue Date

08/31/2023

Effective Date

08/31/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/31/2023