DOMINNO C FOGLE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004161

License Status

ACTIVE

Business

First Name

DOMINNO

Middle

Last Name

FOGLE

Business Name

DOMINNO C FOGLE

Original Issue Date

09/28/2011

Effective Date

01/11/2026

Expiration Date

03/01/2028

City

CARLOCK

State

Zip

61725

County

WOODFORD

Ever Disciplined

LastModifiedDate

01/11/2026