KATHARINE DANIELS VAN FOSSEN MD - Medical Doctor License in Wisconsin | # 036148832

KATHARINE DANIELS VAN FOSSEN MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148832

License Status

NOT RENEWED

Business

N

Title

MD

First Name

KATHARINE

Middle

DANIELS

Last Name

VAN FOSSEN

Business Name

KATHARINE DANIELS VAN FOSSEN MD

Original Issue Date

03/28/2019

Effective Date

03/28/2019

Expiration Date

09/30/2020

State

WI

Ever Disciplined

N

LastModifiedDate

01/14/2021