KAILI FAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

KAILI

Last Name

FAN

Suffix

Business Name

KAILI FAN MD

Original Issue Date

01/30/1996

Effective Date

01/30/1996

Expiration Date

07/31/1999

City

MAYWOOD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020