JEFFREY B BREAUX Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013262

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

Last Name

BREAUX

Business Name

JEFFREY B BREAUX

Original Issue Date

07/14/1981

Effective Date

07/14/1981

Expiration Date

07/01/1983

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006