LISA MARIE FOGT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

First Name

LISA

Middle

MARIE

Last Name

FOGT

Suffix

Business Name

LISA MARIE FOGT MD

Original Issue Date

03/18/2008

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

WINNETKA

State

Zip

60093

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023