CRAYTON A FARGASON JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019409

License Status

EXPIRED

Business

First Name

CRAYTON A

Last Name

FARGASON JR

Suffix

Business Name

CRAYTON A FARGASON JR MD

Original Issue Date

06/12/1986

Effective Date

06/12/1986

Expiration Date

06/24/1989

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006