DAVID FAVREAU FARDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

FAVREAU

Last Name

FARDON

Suffix

Business Name

DAVID FAVREAU FARDON MD

Original Issue Date

07/26/2007

Effective Date

06/16/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023