DAVID MATHEW NIEBRUEGGE Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042666

License Status

CANCELLED

Business

First Name

DAVID

Middle

MATHEW

Last Name

NIEBRUEGGE

Business Name

DAVID MATHEW NIEBRUEGGE

Original Issue Date

06/23/2001

Effective Date

06/23/2001

Expiration Date

06/22/2002

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006