DONALD D VAN FOSSAN JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078909

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

Last Name

VAN FOSSAN

Suffix

JR MD

Business Name

DONALD D VAN FOSSAN JR MD

Original Issue Date

05/23/1989

Effective Date

05/23/1989

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006