LATHA M BRUBAKER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106400

License Status

NOT RENEWED

Business

First Name

LATHA

Middle

Last Name

BRUBAKER

Business Name

LATHA M BRUBAKER

Original Issue Date

03/01/2002

Effective Date

03/01/2002

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

11/29/2006