TIMOTHY DANIEL FAGEN DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137411

License Status

INACTIVE

Business

Title

First Name

TIMOTHY

Middle

DANIEL

Last Name

FAGEN

Business Name

TIMOTHY DANIEL FAGEN DO

Original Issue Date

02/24/2015

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

AUSTIN

State

Zip

78721

Ever Disciplined

LastModifiedDate

04/05/2020