VALERIE MOORE BROSTROM MD - Medical Doctor License in Illinois | # 125055335

VALERIE MOORE BROSTROM MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055335

License Status

CANCELLED

Business

N

Title

MD

First Name

VALERIE

Middle

MOORE

Last Name

BROSTROM

Business Name

VALERIE MOORE BROSTROM MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

State

IL

Specialty/Qualifier

Pathology

Ever Disciplined

N

LastModifiedDate

06/04/2008