MICHAEL PHILIPPE BROUSSEAU Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027821

License Status

EXPIRED

Business

First Name

MICHAEL PHILIPPE

Last Name

BROUSSEAU

Business Name

MICHAEL PHILIPPE BROUSSEAU

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/22/1995

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006