OLUMIDE AYODEJI FANIYAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

OLUMIDE

Middle

AYODEJI

Last Name

FANIYAN

Business Name

OLUMIDE AYODEJI FANIYAN MD

Original Issue Date

06/20/2019

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

BALTIMORE

State

Zip

21201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023