GREGORY GEORGE FENTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066583

License Status

CANCELLED

Business

Title

First Name

GREGORY

Middle

GEORGE

Last Name

FENTON

Business Name

GREGORY GEORGE FENTON MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Clinical Neurophysiology

Ever Disciplined

LastModifiedDate

04/27/2019