MARY J FIDLER Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

FIDLER

Business Name

MARY J FIDLER

Original Issue Date

04/11/2005

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023