ERIN L BRACKBILL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106564

License Status

NOT RENEWED

Business

First Name

ERIN

Middle

Last Name

BRACKBILL

Business Name

ERIN L BRACKBILL

Original Issue Date

03/21/2002

Effective Date

03/21/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

10/27/2006