GLEN ALAN FENTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

Title

First Name

GLEN

Middle

ALAN

Last Name

FENTON

Business Name

GLEN ALAN FENTON MD

Original Issue Date

07/25/2016

Effective Date

05/30/2018

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63104

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021