LEONARD S FAGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

LEONARD S

Last Name

FAGAN

Suffix

Business Name

LEONARD S FAGAN MD

Original Issue Date

04/22/1986

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021