JAMES ELLIS BAGENSTOSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049017

License Status

NOT RENEWED

Business

First Name

JAMES ELLIS

Last Name

BAGENSTOSE

Suffix

Business Name

JAMES ELLIS BAGENSTOSE MD

Original Issue Date

03/26/1974

Effective Date

03/26/1974

City

SAVANNA

State

Zip

61074

County

CARROLL

Ever Disciplined

LastModifiedDate

09/20/2006