DAVID RICHARD BRINE - Medical Doctor License in Illinois | # 125027828

DAVID RICHARD BRINE

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027828

License Status

EXPIRED

Business

N

First Name

DAVID RICHARD

Last Name

BRINE

Business Name

DAVID RICHARD BRINE

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/30/1993

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006