BLAIR F FENTON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020422

License Status

EXPIRED

Business

First Name

BLAIR

Middle

Last Name

FENTON

Business Name

BLAIR F FENTON

Original Issue Date

02/05/1987

Effective Date

02/05/1987

Expiration Date

01/23/1990

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006