STEPHAN KIENZLE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077807

License Status

CANCELLED

Business

Title

First Name

STEPHAN

Last Name

KIENZLE

Business Name

STEPHAN KIENZLE MD

Original Issue Date

06/23/2021

Effective Date

06/23/2021

Expiration Date

06/22/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/15/2021