MARK EDWIN FESENMYER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105597

License Status

NOT RENEWED

Business

First Name

MARK

Middle

EDWIN

Last Name

FESENMYER

Suffix

Business Name

MARK EDWIN FESENMYER MD

Original Issue Date

09/18/2001

Effective Date

05/19/2014

Expiration Date

07/31/2017

City

VALPARAISO

State

Zip

46383

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017