GREGORY LUCIEN FENTON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047919

License Status

EXPIRED

Business

First Name

GREGORY

Middle

LUCIEN

Last Name

FENTON

Suffix

Business Name

GREGORY LUCIEN FENTON MD

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2005

City

WHEATON

State

Zip

60187

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006