ELISSA SUZANNE BREBACH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042686

License Status

EXPIRED

Business

First Name

ELISSA

Middle

SUZANNE

Last Name

BREBACH

Suffix

Business Name

ELISSA SUZANNE BREBACH MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006