MICHAEL ROBERT FETTIPLACE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

ROBERT

Last Name

FETTIPLACE

Business Name

MICHAEL ROBERT FETTIPLACE MD

Original Issue Date

08/28/2023

Effective Date

08/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/28/2023