MITCHELL NORMAN FADDIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

Title

First Name

MITCHELL

Middle

NORMAN

Last Name

FADDIS

Business Name

MITCHELL NORMAN FADDIS MD

Original Issue Date

05/01/2025

Effective Date

05/01/2025

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2025