JUSTIN T FOWLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158727

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

Last Name

FOWLER

Suffix

Business Name

JUSTIN T FOWLER MD

Original Issue Date

11/08/2021

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

07/04/2023