DWIGHT F PENTZIEN JR DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029990

License Status

EXPIRED

Business

Title

First Name

DWIGHT F

Last Name

PENTZIEN JR

Business Name

DWIGHT F PENTZIEN JR DO

Original Issue Date

05/28/1993

Effective Date

05/28/1993

Expiration Date

06/20/1996

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006