JOHN H FAHEY 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

JOHN

Middle

Last Name

FAHEY

Suffix

Business Name

JOHN H FAHEY MD

Original Issue Date

10/24/2003

Effective Date

08/26/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023