RACHANA SURA FOFARIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

RACHANA

Middle

SURA

Last Name

FOFARIA

Suffix

Business Name

RACHANA SURA FOFARIA MD

Original Issue Date

05/16/2007

Effective Date

08/02/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014