CYNTHIA L POORTENGA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

CYNTHIA L

Last Name

POORTENGA

Suffix

Business Name

CYNTHIA L POORTENGA MD

Original Issue Date

03/18/1986

Effective Date

03/18/1986

Expiration Date

07/31/1987

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006