AMALIJA N FAIRBANKS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

AMALIJA N

Last Name

FAIRBANKS

Suffix

Business Name

AMALIJA N FAIRBANKS MD

Original Issue Date

01/17/1985

Effective Date

01/17/1985

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006