RICHARD ALAN FOGERTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051629

License Status

NOT RENEWED

Business

First Name

RICHARD ALAN

Last Name

FOGERTY

Suffix

Business Name

RICHARD ALAN FOGERTY MD

Original Issue Date

08/15/1975

Effective Date

08/15/1975

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006