KELLY J BRUNNER - Medical Doctor License in Illinois | # 125032088

KELLY J BRUNNER

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032088

License Status

EXPIRED

Business

N

First Name

KELLY

Middle

J

Last Name

BRUNNER

Business Name

KELLY J BRUNNER

Original Issue Date

06/30/1994

Effective Date

06/30/1994

Expiration Date

06/28/1995

State

IL

Ever Disciplined

N

LastModifiedDate

09/22/2006