ANDREW Q DE FUNIAK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

First Name

ANDREW

Middle

Last Name

DE FUNIAK

Business Name

ANDREW Q DE FUNIAK

Original Issue Date

10/28/2002

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023