BRENT PATRICK KIMBERLY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042571

License Status

CANCELLED

Business

First Name

BRENT

Middle

PATRICK

Last Name

KIMBERLY

Suffix

Business Name

BRENT PATRICK KIMBERLY DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006