JOSEPH MICHAEL FAGELMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926024

License Status

NOT RENEWED

Business

First Name

JOSEPH

Middle

MICHAEL

Last Name

FAGELMAN

Suffix

Business Name

JOSEPH MICHAEL FAGELMAN OD

Original Issue Date

12/09/1998

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/11/2005