SUSAN M FOWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

FOWELL

Suffix

Business Name

SUSAN M FOWELL MD

Original Issue Date

09/11/1995

Effective Date

09/11/1995

Expiration Date

07/31/2005

City

ELGIN

State

Zip

60123

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020