DONALD L FAGERSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022094

License Status

EXPIRED

Business

First Name

DONALD L

Last Name

FAGERSON

Suffix

Business Name

DONALD L FAGERSON MD

Original Issue Date

05/09/1988

Effective Date

05/09/1988

Expiration Date

06/24/1991

City

CHICAGO

State

Zip

60613

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006