KENNETH J FANTA DC Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038002684

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

FANTA

Suffix

Business Name

KENNETH J FANTA DC

Original Issue Date

11/30/1955

Effective Date

11/30/1955

City

CICERO

State

Zip

60650

County

COOK

Ever Disciplined

LastModifiedDate

09/21/2006