KEITH W BRUNINGA MD - Medical Doctor License in Illinois | # 125027232

KEITH W BRUNINGA MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027232

License Status

EXPIRED

Business

N

First Name

KEITH W

Last Name

BRUNINGA

Suffix

MD

Business Name

KEITH W BRUNINGA MD

Original Issue Date

06/21/1991

Effective Date

06/21/1991

Expiration Date

06/30/1993

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006