DUSTIN RYAN FRAIDENBURG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

Title

First Name

DUSTIN

Middle

RYAN

Last Name

FRAIDENBURG

Business Name

DUSTIN RYAN FRAIDENBURG MD

Original Issue Date

09/20/2012

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023