DERALD ELMER BRACKMANN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038594

License Status

INACTIVE

Business

First Name

DERALD ELMER

Last Name

BRACKMANN

Suffix

Business Name

DERALD ELMER BRACKMANN MD

Original Issue Date

09/13/1963

Effective Date

01/01/1998

Expiration Date

07/31/1987

City

SOUTH PASADENA

State

Zip

91030

Ever Disciplined

LastModifiedDate

02/05/2010