FAWN A LEIGH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

FAWN

Middle

Last Name

LEIGH

Business Name

FAWN A LEIGH

Original Issue Date

03/14/2022

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023