KATHLEEN M FENTZKE MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****07

NOT RENEWED

N

KATHLEEN

M

FENTZKE

MD

KATHLEEN M FENTZKE MD

05/22/2000

05/22/2000

07/31/2002

CHICAGO

IL

60614

COOK

II III IV V

N

10/09/2006