JOHN M BROCKENBROUGH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101927

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

Last Name

BROCKENBROUGH

Business Name

JOHN M BROCKENBROUGH

Original Issue Date

02/07/2000

Effective Date

06/12/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/01/2017