ANDREW LANE FOZZARD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036170696

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

LANE

Last Name

FOZZARD

Business Name

ANDREW LANE FOZZARD MD

Original Issue Date

06/23/2024

Effective Date

06/23/2024

Expiration Date

07/31/2026

City

LEXINGTON

State

Zip

40504

County

FAYETTE

Ever Disciplined

LastModifiedDate

06/23/2024