DAVID THOMAS BROUCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036152848

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

THOMAS

Last Name

BROUCH

Business Name

DAVID THOMAS BROUCH MD

Original Issue Date

05/05/2020

Effective Date

05/05/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023