AMY ERAEME BRODTMANN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048834

License Status

CANCELLED

Business

First Name

AMY

Middle

ERAEME

Last Name

BRODTMANN

Suffix

Business Name

AMY ERAEME BRODTMANN MD

Original Issue Date

11/15/2004

Effective Date

11/15/2004

Expiration Date

11/14/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Behavior Neurology

Ever Disciplined

LastModifiedDate

09/22/2006