MICHELLE SUSANNE FAULL DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136601

License Status

NOT RENEWED

Business

Title

First Name

MICHELLE

Middle

SUSANNE

Last Name

FAULL

Business Name

MICHELLE SUSANNE FAULL DO

Original Issue Date

10/03/2014

Effective Date

09/22/2020

Expiration Date

07/31/2023

City

MIDDLETON

State

Zip

53562

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/30/2023