E DAVID FAUSEL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095214

License Status

ACTIVE

Business

First Name

E DAVID

Last Name

FAUSEL

Business Name

E DAVID FAUSEL

Original Issue Date

04/02/1997

Effective Date

05/23/2023

Expiration Date

07/31/2026

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/23/2023