KELLY J BRUNNER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032088

License Status

EXPIRED

Business

First Name

KELLY

Middle

Last Name

BRUNNER

Business Name

KELLY J BRUNNER

Original Issue Date

06/30/1994

Effective Date

06/30/1994

Expiration Date

06/28/1995

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006