JON SCOTT FANTZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043495

License Status

INACTIVE

Business

First Name

JON SCOTT

Last Name

FANTZ

Suffix

Business Name

JON SCOTT FANTZ MD

Original Issue Date

07/13/1970

Effective Date

07/13/1970

Expiration Date

07/31/1987

City

CONYERS

State

Zip

30207

County

GEORGIA

Ever Disciplined

LastModifiedDate

09/20/2006