EVAN OWEN FOSTER DERANJA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

EVAN

Middle

OWEN FOSTER

Last Name

DERANJA

Business Name

EVAN OWEN FOSTER DERANJA MD

Original Issue Date

12/01/2014

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023