MICHAEL N FENNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036080188

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

Last Name

FENNER

Business Name

MICHAEL N FENNER MD

Original Issue Date

06/29/1990

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/11/2023