GABRIEL TODD FAZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

Title

First Name

GABRIEL

Middle

TODD

Last Name

FAZ

Business Name

GABRIEL TODD FAZ MD

Original Issue Date

03/21/2025

Effective Date

03/21/2025

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/21/2025