PAMELA S FENNEWALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

PAMELA S

Last Name

FENNEWALD

Suffix

Business Name

PAMELA S FENNEWALD MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020