DAVID JACOB FOGELMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062628

License Status

EXPIRED

Business

First Name

DAVID

Middle

JACOB

Last Name

FOGELMAN

Suffix

Business Name

DAVID JACOB FOGELMAN MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

09/04/2015