TRACY ANN FENN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000718

License Status

NOT RENEWED

Business

First Name

TRACY ANN

Last Name

FENN

Business Name

TRACY ANN FENN

Original Issue Date

02/06/1996

Effective Date

02/06/1996

Expiration Date

03/01/1998

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/26/2006