SUSAN M FOWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

FOWELL

Suffix

Business Name

SUSAN M FOWELL MD

Original Issue Date

07/11/1996

Effective Date

07/11/1996

Expiration Date

07/31/2008

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020