JOHANNE THEODULE FAHY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

ACTIVE

Business

First Name

JOHANNE

Middle

THEODULE

Last Name

FAHY

Business Name

JOHANNE THEODULE FAHY

Original Issue Date

01/14/2008

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60643

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/02/2026