ERIK JOHN FOSSEN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

Title

First Name

ERIK

Middle

JOHN

Last Name

FOSSEN

Business Name

ERIK JOHN FOSSEN DO

Original Issue Date

08/20/2018

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023