KEITH W BRUNINGA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027232

License Status

EXPIRED

Business

First Name

KEITH W

Last Name

BRUNINGA

Suffix

Business Name

KEITH W BRUNINGA MD

Original Issue Date

06/21/1991

Effective Date

06/21/1991

Expiration Date

06/30/1993

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006