MICHELLE SUSANNE FAULL DO - Medical Doctor License in Wisconsin | # 036136601

MICHELLE SUSANNE FAULL DO

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136601

License Status

NOT RENEWED

Business

N

Title

DO

First Name

MICHELLE

Middle

SUSANNE

Last Name

FAULL

Business Name

MICHELLE SUSANNE FAULL DO

Original Issue Date

10/03/2014

Effective Date

09/22/2020

Expiration Date

07/31/2023

State

WI

Ever Disciplined

N

LastModifiedDate

11/30/2023