MICHELLE T HAGSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119966

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

HAGSTROM

Suffix

Business Name

MICHELLE T HAGSTROM MD

Original Issue Date

01/15/2008

Effective Date

07/08/2011

Expiration Date

07/31/2014

City

SAINT LOUIS

State

Zip

63108

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/17/2014