THOMAS R FANN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

First Name

THOMAS R

Last Name

FANN

Business Name

THOMAS R FANN

Original Issue Date

01/01/1998

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60626

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006