MICHAEL O HENNEBERRY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

CANCELLED

Business

First Name

MICHAEL O

Last Name

HENNEBERRY

Suffix

Business Name

MICHAEL O HENNEBERRY MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006