TED BROCKETT MD - Medical Doctor License in Illinois | # 036065011

TED BROCKETT MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065011

License Status

NOT RENEWED

Business

N

First Name

TED

Last Name

BROCKETT

Suffix

MD

Business Name

TED BROCKETT MD

Original Issue Date

08/03/1982

Effective Date

08/03/1982

Expiration Date

07/31/1990

State

IL

Ever Disciplined

N

LastModifiedDate

09/20/2006