BRIAN ALEXANDER BRAITHWAITE MD - Medical Doctor License in Illinois | # 125059899

BRIAN ALEXANDER BRAITHWAITE MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059899

License Status

CANCELLED

Business

N

Title

MD

First Name

BRIAN

Middle

ALEXANDER

Last Name

BRAITHWAITE

Business Name

BRIAN ALEXANDER BRAITHWAITE MD

Original Issue Date

06/23/2014

Effective Date

06/23/2014

Expiration Date

06/22/2015

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

03/24/2014