DONALD DUANE VANFOSSAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042399

License Status

INACTIVE

Business

First Name

DONALD DUANE

Last Name

VANFOSSAN

Suffix

Business Name

DONALD DUANE VANFOSSAN MD

Original Issue Date

01/31/1969

Effective Date

01/31/1969

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/09/2006