KEVIN J FAGAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

ACTIVE

Business

First Name

KEVIN J

Last Name

FAGAN

Suffix

Business Name

KEVIN J FAGAN MD

Original Issue Date

07/24/1984

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023