DAVID PARKER FAXON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

PARKER

Last Name

FAXON

Suffix

Business Name

DAVID PARKER FAXON MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008