CRYSTAL ANN FOX MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138072

License Status

NOT RENEWED

Business

Title

First Name

CRYSTAL

Middle

ANN

Last Name

FOX

Business Name

CRYSTAL ANN FOX MD

Original Issue Date

05/26/2015

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021