RETTA E BRECKENRIDGE PELSANG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122451

License Status

NOT RENEWED

Business

First Name

RETTA

Middle

Last Name

BRECKENRIDGE PELSANG

Suffix

Business Name

RETTA E BRECKENRIDGE PELSANG MD

Original Issue Date

01/14/2009

Effective Date

05/24/2017

Expiration Date

09/30/2020

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

01/14/2021