H JAY BRUNINGA OD MD - Medical Doctor License in Illinois | # 125018833

H JAY BRUNINGA OD MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018833

License Status

EXPIRED

Business

N

First Name

H JAY

Last Name

BRUNINGA

Suffix

OD MD

Business Name

H JAY BRUNINGA OD MD

Original Issue Date

07/09/1985

Effective Date

07/09/1985

Expiration Date

07/01/1988

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006