BRENTON B KOCH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000132

License Status

EXPIRED

Business

First Name

BRENTON

Middle

Last Name

KOCH

Suffix

Business Name

BRENTON B KOCH MD

Original Issue Date

06/15/2001

Effective Date

06/15/2001

Expiration Date

07/01/2001

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006