MARTIN RYAN FETZER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

MARTIN

Middle

RYAN

Last Name

FETZER

Business Name

MARTIN RYAN FETZER DO

Original Issue Date

10/13/2011

Effective Date

06/01/2023

Expiration Date

07/31/2026

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/01/2023