HEATHER A BROOCK - Medical Doctor License in Illinois | # 125032819

HEATHER A BROOCK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032819

License Status

EXPIRED

Business

N

First Name

HEATHER

Middle

A

Last Name

BROOCK

Business Name

HEATHER A BROOCK

Original Issue Date

05/30/1995

Effective Date

05/30/1995

Expiration Date

06/23/1998

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006