PHYLLIS S BREALL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027870

License Status

EXPIRED

Business

First Name

PHYLLIS S

Last Name

BREALL

Business Name

PHYLLIS S BREALL

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/21/1995

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006