PHILIP GREGORY FIELDS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111155

License Status

INACTIVE

Business

First Name

PHILIP

Middle

GREGORY

Last Name

FIELDS

Suffix

Business Name

PHILIP GREGORY FIELDS MD

Original Issue Date

04/06/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

LOUISVILLE

State

Zip

40257

County

KENTUCKY

Ever Disciplined

LastModifiedDate

07/31/2008