JUSTIN MARK BROOKS MD - Medical Doctor License in Illinois | # 125057595

JUSTIN MARK BROOKS MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057595

License Status

CANCELLED

Business

N

Title

MD

First Name

JUSTIN

Middle

MARK

Last Name

BROOKS

Business Name

JUSTIN MARK BROOKS MD

Original Issue Date

06/26/2010

Effective Date

06/26/2010

Expiration Date

06/25/2013

State

IL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

N

LastModifiedDate

05/04/2010