TIMOTHY EAMON FAHEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

EAMON

Last Name

FAHEY

Business Name

TIMOTHY EAMON FAHEY MD

Original Issue Date

03/13/2018

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023