License holder summary

Fogt, Nathan-Mercy Defiance Clinic is a Medical Board - 41.Pa Supervision Agreement licensed to practice in Ohio. The address on file for Fogt, Nathan-Mercy Defiance Clinic is Jasen Issa, 1400 E. Second St., Orthopedics, Defiance, OH 43512. This licensed professional license is current. The license was granted 09/24/2012 and expired on 01/31/2015.

Ohio

Board of Licensing

Fogt, Nathan-Mercy Defiance Clinic
Medical Board - 41.Pa Supervision Agreement
License number
41.15395-SA
Date granted
09/24/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
Jasen Issa, 1400 E. Second St., Orthopedics, Defiance, OH 43512
ohiolicensing.org
ID 29522639
LAST UPDATED 2024-03-20 19:08:30 UTC

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