SANDRA KREPLICK FERNBACH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

SANDRA KREPLICK

Last Name

FERNBACH

Suffix

Business Name

SANDRA KREPLICK FERNBACH MD

Original Issue Date

05/08/1998

Effective Date

05/16/2011

Expiration Date

07/31/2014

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014