MARK ADRIAN FAASSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

ADRIAN

Last Name

FAASSE

Business Name

MARK ADRIAN FAASSE MD

Original Issue Date

08/08/2013

Effective Date

06/30/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020