DAVID B FAGAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086073

License Status

INACTIVE

Business

First Name

DAVID B

Last Name

FAGAN

Suffix

Business Name

DAVID B FAGAN MD

Original Issue Date

05/18/1993

Effective Date

05/18/1993

Expiration Date

07/31/1996

City

ST LOUIS

State

Zip

63128

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006