DANIEL JOHN BREAULT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049041

License Status

EXPIRED

Business

First Name

DANIEL

Middle

JOHN

Last Name

BREAULT

Suffix

Business Name

DANIEL JOHN BREAULT MD

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2008

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/26/2008