GLENN WAYNE FOWLER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040883

License Status

INACTIVE

Business

First Name

GLENN WAYNE

Last Name

FOWLER

Suffix

Business Name

GLENN WAYNE FOWLER MD

Original Issue Date

01/20/1967

Effective Date

01/20/1967

Expiration Date

07/31/1987

City

ORANGE

State

Zip

92668

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006