MATTHEW EDWARD HENNIG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

EDWARD

Last Name

HENNIG

Suffix

Business Name

MATTHEW EDWARD HENNIG MD

Original Issue Date

07/02/2010

Effective Date

07/01/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020