JACOB Z BRUDOLEY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035320

License Status

EXPIRED

Business

First Name

JACOB

Middle

Last Name

BRUDOLEY

Business Name

JACOB Z BRUDOLEY

Original Issue Date

07/01/1996

Effective Date

07/01/1996

Expiration Date

06/30/1998

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006