GARY RICHARD FAHRENBACH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

GARY RICHARD

Last Name

FAHRENBACH

Suffix

Business Name

GARY RICHARD FAHRENBACH MD

Original Issue Date

01/01/1997

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023