MICHAEL GREGORY FAZIO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

GREGORY

Last Name

FAZIO

Business Name

MICHAEL GREGORY FAZIO DO

Original Issue Date

06/27/2020

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

ROCKVILLE

State

Zip

20855

County

MONTGOMERY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023