JAN HENRY FAIBISOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057642

License Status

NOT RENEWED

Business

First Name

JAN HENRY

Last Name

FAIBISOFF

Suffix

Business Name

JAN HENRY FAIBISOFF MD

Original Issue Date

09/25/1978

Effective Date

06/27/2017

Expiration Date

09/30/2020

City

CASEYVILLE

State

Zip

62232

County

ARIZONA

Ever Disciplined

LastModifiedDate

01/14/2021