BRENT A NIELSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100743

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

Last Name

NIELSEN

Suffix

Business Name

BRENT A NIELSEN MD

Original Issue Date

07/21/1999

Effective Date

07/21/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2007