MITCHELL F FAGELMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108429

License Status

NOT RENEWED

Business

First Name

MITCHELL

Middle

Last Name

FAGELMAN

Suffix

Business Name

MITCHELL F FAGELMAN MD

Original Issue Date

01/14/2003

Effective Date

01/14/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006