ELLIOTT C DASENBROOK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110830

License Status

NOT RENEWED

Business

First Name

ELLIOTT

Middle

Last Name

DASENBROOK

Business Name

ELLIOTT C DASENBROOK

Original Issue Date

02/18/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008