MANDANA FAGHANI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

Title

First Name

MANDANA

Last Name

FAGHANI

Business Name

MANDANA FAGHANI MD

Original Issue Date

08/31/2011

Effective Date

08/31/2011

Expiration Date

07/31/2014

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/11/2017