FAY PEMA V BAGARINAO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

FAY PEMA

Middle

Last Name

BAGARINAO

Suffix

Business Name

FAY PEMA V BAGARINAO MD

Original Issue Date

06/24/2002

Effective Date

05/23/2008

Expiration Date

07/31/2011

City

BETHALTO

State

Zip

62010

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017