DIANE L FABRICIUS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

DIANE L

Last Name

FABRICIUS

Suffix

Business Name

DIANE L FABRICIUS MD

Original Issue Date

10/19/1983

Effective Date

10/19/1983

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60626

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006