PETER THOMAS FAGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

PETER THOMAS

Last Name

FAGAN

Suffix

Business Name

PETER THOMAS FAGAN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1993

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006