RICHARD N FEDORAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

RICHARD N

Last Name

FEDORAK

Suffix

Business Name

RICHARD N FEDORAK MD

Original Issue Date

09/27/1982

Effective Date

09/27/1982

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006