FAIROUZ C CODINA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

Title

First Name

FAIROUZ

Middle

Last Name

CODINA

Business Name

FAIROUZ C CODINA MD

Original Issue Date

07/23/2020

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60601

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023