DAVID W FAIRBANKS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094349

License Status

NOT RENEWED

Business

First Name

DAVID W

Last Name

FAIRBANKS

Suffix

Business Name

DAVID W FAIRBANKS MD

Original Issue Date

10/09/1996

Effective Date

10/09/1996

Expiration Date

07/31/1999

City

SPANISH FORK

State

Zip

84660

County

UTAH

Ever Disciplined

LastModifiedDate

09/26/2007