BRIDGET SUSAN BANACH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137292

License Status

ACTIVE

Business

Title

First Name

BRIDGET

Middle

SUSAN

Last Name

BANACH

Business Name

BRIDGET SUSAN BANACH MD

Original Issue Date

02/11/2015

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

GENEVA

State

Zip

60134

County

KANE

Ever Disciplined

LastModifiedDate

04/21/2023