ENA ELIZABETH HENNEGAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035984

License Status

CANCELLED

Business

First Name

ENA

Middle

ELIZABETH

Last Name

HENNEGAN

Suffix

Business Name

ENA ELIZABETH HENNEGAN DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/19/2001

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006