RETTA E BRECKENRIDGE PELSANG MD - Medical Doctor License in Illinois | # 036122451

RETTA E BRECKENRIDGE PELSANG MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122451

License Status

NOT RENEWED

Business

N

First Name

RETTA

Middle

E

Last Name

BRECKENRIDGE PELSANG

Suffix

MD

Business Name

RETTA E BRECKENRIDGE PELSANG MD

Original Issue Date

01/14/2009

Effective Date

05/24/2017

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021