TED BROCKETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065011

License Status

NOT RENEWED

Business

First Name

TED

Last Name

BROCKETT

Suffix

Business Name

TED BROCKETT MD

Original Issue Date

08/03/1982

Effective Date

08/03/1982

Expiration Date

07/31/1990

City

CLARENDON HILLS

State

Zip

60514

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006