MING FAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

CANCELLED

Business

First Name

MING

Last Name

FAN

Suffix

Business Name

MING FAN MD

Original Issue Date

01/29/2004

Effective Date

01/29/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006