DAVID MALCOLM BRENTNALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095661

License Status

NOT RENEWED

Business

First Name

DAVID MALCOLM

Last Name

BRENTNALL

Suffix

Business Name

DAVID MALCOLM BRENTNALL MD

Original Issue Date

06/19/1997

Effective Date

06/19/1997

Expiration Date

07/31/2002

City

PETERSBURG

State

Zip

62675

County

MENARD

Ever Disciplined

LastModifiedDate

10/09/2006