DI FAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

Last Name

FAN

Suffix

Business Name

DI FAN MD

Original Issue Date

06/10/2009

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2023