ANDY AGEN DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054434

License Status

NOT RENEWED

Business

First Name

ANDY AGEN

Last Name

DAVIS

Suffix

Business Name

ANDY AGEN DAVIS MD

Original Issue Date

04/14/1977

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021