STACEY BETH PRENNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135332

License Status

NOT RENEWED

Business

Title

First Name

STACEY

Middle

BETH

Last Name

PRENNER

Business Name

STACEY BETH PRENNER MD

Original Issue Date

05/14/2014

Effective Date

05/14/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017