LEONARD F FAGAN JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036074867

License Status

NOT RENEWED

Business

First Name

LEONARD F

Last Name

FAGAN JR

Suffix

Business Name

LEONARD F FAGAN JR MD

Original Issue Date

04/17/1987

Effective Date

08/03/2010

Expiration Date

07/31/2011

City

SAINT LOUIS

State

Zip

63122

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/14/2011