JULIE RUTH FAGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142421

License Status

NOT RENEWED

Business

Title

First Name

JULIE

Middle

RUTH

Last Name

FAGAN

Business Name

JULIE RUTH FAGAN MD

Original Issue Date

02/16/2017

Effective Date

02/16/2017

Expiration Date

07/31/2017

City

MADISON

State

Zip

53719

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/01/2017