STANLEY JOHN FUDALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101664

License Status

NOT RENEWED

Business

First Name

STANLEY

Middle

JOHN

Last Name

FUDALA

Suffix

Business Name

STANLEY JOHN FUDALA MD

Original Issue Date

12/02/1999

Effective Date

07/28/2014

Expiration Date

07/31/2017

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/01/2017