BRIAN M BROTZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018804

License Status

EXPIRED

Business

First Name

BRIAN M

Last Name

BROTZ

Business Name

BRIAN M BROTZ

Original Issue Date

06/26/1985

Effective Date

06/26/1985

Expiration Date

07/01/1988

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006