LAUREN FORMELLA BROOKS DO - Medical Doctor License in Illinois | # 036151003

LAUREN FORMELLA BROOKS DO

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151003

License Status

NOT RENEWED

Business

N

Title

DO

First Name

LAUREN

Middle

FORMELLA

Last Name

BROOKS

Business Name

LAUREN FORMELLA BROOKS DO

Original Issue Date

10/11/2019

Effective Date

10/11/2019

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021