JOSEPH MICHAEL FAGELMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927593

License Status

NOT RENEWED

Business

First Name

JOSEPH

Middle

MICHAEL

Last Name

FAGELMAN

Suffix

Business Name

JOSEPH MICHAEL FAGELMAN OD

Original Issue Date

11/15/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/11/2005