PHILIP A BRANSHAW - Medical Doctor License in Illinois | # 125031503

PHILIP A BRANSHAW

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031503

License Status

EXPIRED

Business

N

First Name

PHILIP A

Last Name

BRANSHAW

Business Name

PHILIP A BRANSHAW

Original Issue Date

05/25/1994

Effective Date

05/25/1994

Expiration Date

06/30/1997

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006