CHRISTOPHER ANTONIO BRACKSHAW DO - Medical Doctor License in Illinois | # 130001186

CHRISTOPHER ANTONIO BRACKSHAW DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001186

License Status

EXPIRED

Business

N

Title

DO

First Name

CHRISTOPHER

Middle

ANTONIO

Last Name

BRACKSHAW

Business Name

CHRISTOPHER ANTONIO BRACKSHAW DO

Original Issue Date

11/20/2017

Effective Date

11/20/2017

Expiration Date

12/19/2017

State

IL

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

N

LastModifiedDate

04/10/2018