BRADLEY RICHARD HENNENFENT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017344

License Status

EXPIRED

Business

First Name

BRADLEY

Middle

RICHARD

Last Name

HENNENFENT

Suffix

Business Name

BRADLEY RICHARD HENNENFENT MD

Original Issue Date

06/26/1984

Effective Date

06/26/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006