TED W FAULL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082109

License Status

NOT RENEWED

Business

First Name

TED W

Last Name

FAULL

Suffix

Business Name

TED W FAULL MD

Original Issue Date

02/26/1991

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

YOUNGSTOWN

State

Zip

44512

Ever Disciplined

LastModifiedDate

11/14/2011