CHAD RYAN FOWLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113662

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

RYAN

Last Name

FOWLER

Suffix

Business Name

CHAD RYAN FOWLER MD

Original Issue Date

05/12/2005

Effective Date

06/23/2008

Expiration Date

07/31/2011

City

O'FALLON

State

Zip

63366

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/14/2011