MICHAEL N FENNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

Last Name

FENNER

Business Name

MICHAEL N FENNER MD

Original Issue Date

03/21/1991

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023