GREGORY L BROTZMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016976

License Status

EXPIRED

Business

First Name

GREGORY L

Last Name

BROTZMAN

Suffix

Business Name

GREGORY L BROTZMAN MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

07/01/1986

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006