JEFFREY DAVID FOGLE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

Title

First Name

JEFFREY

Middle

DAVID

Last Name

FOGLE

Business Name

JEFFREY DAVID FOGLE MD

Original Issue Date

03/11/2020

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

STILLMAN VALLEY

State

Zip

61084

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2023