CRAYTON A FARGASON JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

CRAYTON A

Last Name

FARGASON JR

Suffix

Business Name

CRAYTON A FARGASON JR MD

Original Issue Date

01/22/1990

Effective Date

01/22/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006