PORTIA S BONEBRAKE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044748

License Status

EXPIRED

Business

Title

First Name

PORTIA

Middle

Last Name

BONEBRAKE

Business Name

PORTIA S BONEBRAKE MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006