MADONNA FABIAN 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

MADONNA

Last Name

FABIAN

Business Name

MADONNA FABIAN MD

Original Issue Date

06/23/2017

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

90041

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023