KIMBERLY E BROCKENBROUGH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036157

License Status

EXPIRED

Business

First Name

KIMBERLY

Middle

Last Name

BROCKENBROUGH

Business Name

KIMBERLY E BROCKENBROUGH

Original Issue Date

05/19/1997

Effective Date

05/19/1997

Expiration Date

06/21/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006