ERICH WOLFGANG FANTL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036023583

License Status

INACTIVE

Business

First Name

ERICH WOLFGANG

Last Name

FANTL

Suffix

Business Name

ERICH WOLFGANG FANTL MD

Original Issue Date

02/26/1940

Effective Date

02/26/1940

Expiration Date

07/31/1987

City

SCOTTSDALE

State

Zip

85258

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/20/2006