RICHARD E FAUSEL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017524

License Status

EXPIRED

Business

First Name

RICHARD

Middle

Last Name

FAUSEL

Business Name

RICHARD E FAUSEL

Original Issue Date

07/17/1984

Effective Date

07/17/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006