GEOFFREY C FENNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

Title

First Name

GEOFFREY

Middle

Last Name

FENNER

Business Name

GEOFFREY C FENNER MD

Original Issue Date

08/08/1996

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

KENILWORTH

State

Zip

60043

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023