FADI I ISA DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****61

License Status

ACTIVE

Business

Title

DPM

First Name

FADI

Middle

Last Name

ISA

Business Name

FADI I ISA DPM

Original Issue Date

09/03/2025

Effective Date

09/03/2025

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/03/2025