KEVIN M FAHEY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

First Name

KEVIN M

Last Name

FAHEY

Business Name

KEVIN M FAHEY

Original Issue Date

09/19/2002

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023