JACQUELINE FABRICIUS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

Title

First Name

JACQUELINE

Last Name

FABRICIUS

Business Name

JACQUELINE FABRICIUS MD

Original Issue Date

10/20/2022

Effective Date

06/01/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/01/2023