CRAIG A FENTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

CANCELLED

Business

First Name

CRAIG A

Last Name

FENTON

Suffix

Business Name

CRAIG A FENTON MD

Original Issue Date

01/01/1997

Effective Date

04/19/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014