AGATHA M S BOGARD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050905

License Status

CANCELLED

Business

First Name

AGATHA

Middle

M S

Last Name

BOGARD

Suffix

Business Name

AGATHA M S BOGARD MD

Original Issue Date

06/19/2006

Effective Date

06/19/2006

Expiration Date

06/18/2009

City

KALAMAZOO

State

Zip

49009

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/22/2006