EDWARD FRANCIS FOGARTY III MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

Title

First Name

EDWARD

Middle

FRANCIS

Last Name

FOGARTY III

Business Name

EDWARD FRANCIS FOGARTY III MD

Original Issue Date

03/31/2020

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

08/01/2023