CYNTHIA MARIE FOWLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

CYNTHIA

Middle

MARIE

Last Name

FOWLER

Suffix

Business Name

CYNTHIA MARIE FOWLER MD

Original Issue Date

07/28/2004

Effective Date

07/28/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008