MARK V FAIRHURST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036084310

License Status

NOT RENEWED

Business

First Name

MARK V

Last Name

FAIRHURST

Suffix

Business Name

MARK V FAIRHURST MD

Original Issue Date

04/24/1992

Effective Date

04/24/1992

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/20/2006