RYAN JOHN BRENZA DO - Medical Doctor License in Illinois | # 125044222

RYAN JOHN BRENZA DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044222

License Status

CANCELLED

Business

N

First Name

RYAN

Middle

JOHN

Last Name

BRENZA

Suffix

DO

Business Name

RYAN JOHN BRENZA DO

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006