JEFFREY J FAGERLAND Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023085

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

Last Name

FAGERLAND

Business Name

JEFFREY J FAGERLAND

Original Issue Date

07/29/1988

Effective Date

07/29/1988

Expiration Date

07/29/1991

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006