DAVID JACOB FJELDSTED MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000525

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

JACOB

Last Name

FJELDSTED

Suffix

Business Name

DAVID JACOB FJELDSTED MD

Original Issue Date

10/25/2013

Effective Date

10/25/2013

Expiration Date

04/24/2014

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

08/12/2014