JEFFREY S BRAULT DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032492

License Status

EXPIRED

Business

Title

First Name

JEFFREY S

Last Name

BRAULT

Business Name

JEFFREY S BRAULT DO

Original Issue Date

05/10/1995

Effective Date

05/10/1995

Expiration Date

06/20/1996

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006