BRIAN J HETTRICK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033434

License Status

EXPIRED

Business

First Name

BRIAN

Middle

Last Name

HETTRICK

Business Name

BRIAN J HETTRICK

Original Issue Date

06/17/1995

Effective Date

06/17/1995

Expiration Date

06/30/1998

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006