BRENT RICHARD CHAMBERLAIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038130

License Status

EXPIRED

Business

First Name

BRENT

Middle

RICHARD

Last Name

CHAMBERLAIN

Suffix

Business Name

BRENT RICHARD CHAMBERLAIN MD

Original Issue Date

06/01/1998

Effective Date

06/01/1998

Expiration Date

06/30/1999

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006