JEFFRY J FASSERO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019746

License Status

EXPIRED

Business

First Name

JEFFRY

Middle

Last Name

FASSERO

Business Name

JEFFRY J FASSERO

Original Issue Date

06/26/1986

Effective Date

06/26/1986

Expiration Date

06/26/1989

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006