JERALD J BRATBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052806

License Status

NOT RENEWED

Business

First Name

JERALD J

Last Name

BRATBERG

Suffix

Business Name

JERALD J BRATBERG MD

Original Issue Date

06/08/1976

Effective Date

07/13/2011

Expiration Date

07/31/2014

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/17/2014