BRUCE JEFFREY BRENER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000037

License Status

EXPIRED

Business

First Name

BRUCE JEFFREY

Last Name

BRENER

Business Name

BRUCE JEFFREY BRENER

Original Issue Date

09/12/1996

Effective Date

09/12/1996

Expiration Date

04/30/1997

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/23/2006