KIMBERLY A FENZL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058028

License Status

CANCELLED

Business

Title

First Name

KIMBERLY

Middle

Last Name

FENZL

Business Name

KIMBERLY A FENZL MD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

04/27/2010