BRADLEY RICHARD HENNENFENT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

BRADLEY

Middle

RICHARD

Last Name

HENNENFENT

Suffix

Business Name

BRADLEY RICHARD HENNENFENT MD

Original Issue Date

07/26/1985

Effective Date

07/26/1985

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006