MIKAELA ROSE FENN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078512

License Status

EXPIRED

Business

Title

First Name

MIKAELA

Middle

ROSE

Last Name

FENN

Business Name

MIKAELA ROSE FENN MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/30/2024