SUSAN MICHELLE FANAPOUR DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

SUSAN

Middle

MICHELLE

Last Name

FANAPOUR

Suffix

Business Name

SUSAN MICHELLE FANAPOUR DO

Original Issue Date

02/14/2002

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023