WILLIAM THOMAS FOGARTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

WILLIAM

Middle

THOMAS

Last Name

FOGARTY

Suffix

Business Name

WILLIAM THOMAS FOGARTY MD

Original Issue Date

01/13/1997

Effective Date

01/13/1997

Expiration Date

07/31/1999

City

ITASCA

State

Zip

60143

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011