GREGORY WAYNE FARIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

Title

First Name

GREGORY

Middle

WAYNE

Last Name

FARIS

Business Name

GREGORY WAYNE FARIS MD

Original Issue Date

02/09/2010

Effective Date

02/09/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011