DOUGLAS S FENTON MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****89

NOT RENEWED

N

DOUGLAS

S

FENTON

MD

DOUGLAS S FENTON MD

07/06/1994

07/06/1994

07/31/1996

CHICAGO

IL

60610

COOK

II III IV V

N

09/26/2006