LEONARD F FAGAN JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

LEONARD F

Last Name

FAGAN JR

Suffix

Business Name

LEONARD F FAGAN JR MD

Original Issue Date

12/31/1987

Effective Date

08/26/2010

Expiration Date

07/31/2011

City

SAINT LOUIS

State

Zip

63122

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011