PAMELA S FENNEWALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

PAMELA S

Last Name

FENNEWALD

Suffix

Business Name

PAMELA S FENNEWALD MD

Original Issue Date

04/21/1989

Effective Date

05/18/2017

Expiration Date

09/30/2020

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021