BURT FAIBISOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

BURT

Last Name

FAIBISOFF

Suffix

Business Name

BURT FAIBISOFF MD

Original Issue Date

10/02/1981

Effective Date

10/02/1981

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006