PHILIP JOHN FITZPATRICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

PHILIP

Middle

JOHN

Last Name

FITZPATRICK

Suffix

Business Name

PHILIP JOHN FITZPATRICK MD

Original Issue Date

08/01/2003

Effective Date

08/01/2003

Expiration Date

07/31/2008

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008