MONIQUE MAZAL BROTMAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041903

License Status

EXPIRED

Business

First Name

MONIQUE

Middle

MAZAL

Last Name

BROTMAN

Business Name

MONIQUE MAZAL BROTMAN

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006