ANDREA R PENEPACKER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037736

License Status

EXPIRED

Business

First Name

ANDREA

Middle

Last Name

PENEPACKER

Suffix

Business Name

ANDREA R PENEPACKER MD

Original Issue Date

06/22/1998

Effective Date

06/22/1998

Expiration Date

06/21/2001

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006