BRIAN KEITH BONISH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046218

License Status

EXPIRED

Business

Title

First Name

BRIAN

Middle

KEITH

Last Name

BONISH

Business Name

BRIAN KEITH BONISH MD

Original Issue Date

06/22/2003

Effective Date

06/22/2003

Expiration Date

06/30/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

07/31/2008