Utah
Division of Occupational and Professional Licensing
FARREL KEITH VANWAGENEN
Physician - Physician & Surgeon
License number
6291275-1205
Date granted
09/07/2006
Date expires
01/31/2012
Class
Physician - Physician & Surgeon
Status
Expired
Address
COLORADO SPRINGS, CO 80906
utahlicensing.org
ID 29923633
LAST UPDATED 2024-05-08 21:52:07 UTC
LAST UPDATED 2024-05-08 21:52:07 UTC
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