TRACY P MILBRANDT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039138

License Status

EXPIRED

Business

First Name

TRACY

Middle

Last Name

MILBRANDT

Business Name

TRACY P MILBRANDT

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

PEORIA HEIGHTS

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006