EDWARD BOONE BRACKETT III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037881

License Status

NOT RENEWED

Business

First Name

EDWARD BOONE

Last Name

BRACKETT III

Suffix

Business Name

EDWARD BOONE BRACKETT III MD

Original Issue Date

09/12/1962

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

01/14/2021