BRENT DAVID BEVARD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035654

License Status

EXPIRED

Business

First Name

BRENT

Middle

DAVID

Last Name

BEVARD

Suffix

Business Name

BRENT DAVID BEVARD DO

Original Issue Date

04/11/1997

Effective Date

04/11/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006