MICHAEL O HENNEBERRY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051979

License Status

NOT RENEWED

Business

First Name

MICHAEL O

Last Name

HENNEBERRY

Suffix

Business Name

MICHAEL O HENNEBERRY MD

Original Issue Date

10/17/1975

Effective Date

10/17/1975

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006