ANTHONY OMAR FOULEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

First Name

ANTHONY

Middle

OMAR

Last Name

FOULEN

Suffix

Business Name

ANTHONY OMAR FOULEN MD

Original Issue Date

04/09/2004

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023