RISHA R FENNELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036777

License Status

EXPIRED

Business

Title

First Name

RISHA

Middle

Last Name

FENNELL

Business Name

RISHA R FENNELL MD

Original Issue Date

06/16/1997

Effective Date

06/16/1997

Expiration Date

06/30/2000

City

POLO

State

Zip

61064

County

OGLE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006