FADEL BOFARRAG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

Title

First Name

FADEL

Last Name

BOFARRAG

Business Name

FADEL BOFARRAG MD

Original Issue Date

06/17/2024

Effective Date

06/17/2024

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026