KEVIN PATRICK FITZGERALD MD ` Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

KEVIN

Middle

PATRICK

Last Name

FITZGERALD

Suffix

Business Name

KEVIN PATRICK FITZGERALD MD `

Original Issue Date

11/16/2000

Effective Date

11/16/2000

Expiration Date

07/31/2005

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017