JOHN M BROCKENBROUGH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035956

License Status

EXPIRED

Business

First Name

JOHN

Middle

Last Name

BROCKENBROUGH

Business Name

JOHN M BROCKENBROUGH

Original Issue Date

05/12/1997

Effective Date

05/12/1997

Expiration Date

06/30/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006